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General NPI Number Information
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NPI Number | 1972799435
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Entity Type | Organization
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Legal Business Name | NORTH CENTRAL TEXAS SPINE INSTITUTE
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Dates
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Enumeration Date | 09/19/2007
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Last Update Date | 04/24/2018
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Provider Practice Location Address
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Address Line | 729 W BEDFORD EULESS RD STE 206
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City | HURST
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State | TX
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Zip | 76053-3941
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Country | US
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Telephone | 817-288-0084
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Fax | 817-445-1039
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Provider Business Mailing Address
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Address Line | 729 W BEDFORD EULESS RD STE 206
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City | HURST
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State | TX
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Zip | 76053-3941
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Country | US
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Telephone | 817-288-0084
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Fax | 817-445-1039
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Authorized Official
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Title or Position | OWNER
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Name | DR. ROBERT MYLES
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Credential | MD
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Telephone | 817-288-0084
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | K1579
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License Number State | TX
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