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NPI Code Detail

MEDICARE: DAVID BACK CLINIC OF AMERICA, INC.

MEDICARE: DAVID BACK CLINIC OF AMERICA, INC.
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
12081P0004XSpinal Cord Injury Medicine Physician

General Provider Information

NPI Number : 1720282122
Entity Type Code : Organization
Provider Name (Legal Business Name) : DAVID BACK CLINIC OF AMERICA, INC.
Provider Business Mailing Address
First Line : 7148 TRAIL LAKE DR
Second Line :
City : FORT WORTH
State : TX
Zip : 76123-1969
Country : US
Telephone Number : 817-921-9983
Fax Number : 817-763-9985
Provider Business Practice Location Address
First Line : 7148 TRAIL LAKE DR
Second Line :
City : FORT WORTH
State : TX
Zip : 76123-1969
Country : US
Telephone Number : 817-921-9983
Fax Number : 817-763-9985
Authorized Official
Title or Position : PARTNER -VP NATIONAL DEVELOPMENT
Name : BOB SCHLINKMAN
Credential :
Telephone Number : 972-839-3250
Provider Enumeration Date : 06/12/2007
Last Update Date : 08/22/2020

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