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General NPI Number Information
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NPI Number | 1912923376
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Entity Type | Organization
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Legal Business Name | PEDIATRIC SPORTS AND SPINE ASSOCIATES
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Dates
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Enumeration Date | 07/15/2006
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Last Update Date | 04/14/2008
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Provider Practice Location Address
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Address Line | 2020 W STATE HIGHWAY 114 SUITE 110
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City | GRAPEVINE
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State | TX
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Zip | 76051-8649
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Country | US
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Telephone | 817-310-0810
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Fax | 817-812-3525
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Provider Business Mailing Address
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Address Line | 2020 W STATE HIGHWAY 114 SUITE 110
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City | GRAPEVINE
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State | TX
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Zip | 76051-8649
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Country | US
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Telephone | 817-310-0810
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Fax | 817-812-3525
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DAVID SCOTT BROWN
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Credential | M.D.
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Telephone | 817-310-0810
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207XP3100X
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Taxonomy Name | Pediatric Orthopaedic Surgery Physician
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License Number |
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License Number State |
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