MEDICARE: WESTLAKE ORTHOPAEDICS SPINE & SPORTS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207X00000X	Orthopaedic Surgery Physician	K1685	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1023110129
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WESTLAKE ORTHOPAEDICS SPINE & SPORTS

Provider Business Mailing Address
First Line	:	5656 BEE CAVES RD.
Second Line	:	K-200
City	:	AUSTIN
State	:	TX
Zip	:	78746-5811
Country	:	US
Telephone Number	:	512-329-6644
Fax Number	:	512-891-6562

Provider Business Practice Location Address
First Line	:	5656 BEE CAVES RD
Second Line	:	K-200
City	:	AUSTIN
State	:	TX
Zip	:	78746-5811
Country	:	US
Telephone Number	:	512-329-6644
Fax Number	:	512-891-6562

Authorized Official
Title or Position	:	OWNER
Name	:	SCOTT W. SPANN
Credential	:	M.D.
Telephone Number	:	512-329-6644

Provider Enumeration Date	:	09/01/2006
Last Update Date	:	05/04/2012

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Directions to “WESTLAKE ORTHOPAEDICS SPINE & SPORTS ” Practice Location

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