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General NPI Number Information
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NPI Number | 1902111651
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Entity Type | Organization
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Legal Business Name | TEXAS SPINE CONSULTANTS, LLP
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Dates
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Enumeration Date | 08/18/2010
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Last Update Date | 10/16/2024
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Provider Practice Location Address
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Address Line | 3465 NATIONAL DR STE 200
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City | PLANO
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State | TX
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Zip | 75025-1095
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Country | US
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Telephone | 214-370-3535
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Fax | 214-828-1379
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Provider Business Mailing Address
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Address Line | 17051 DALLAS PKWY STE 400
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City | ADDISON
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State | TX
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Zip | 75001-7108
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Country | US
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Telephone | 214-370-3535
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Fax | 214-970-0004
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. ANDREW PARK
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Credential | M.D.
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Telephone | 214-370-3535
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208VP0000X
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Taxonomy Name | Pain Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207XS0117X
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Taxonomy Name | Orthopaedic Surgery of the Spine Physician
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License Number |
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License Number State |
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