MEDICARE: DESOTO SPINE CENTER, PLLC

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	111N00000X	Chiropractor	5472	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	84NV	OTHER	TX	BLUE CROSS/BLUE SHIELD

General Provider Information

NPI Number	:	1760718175
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DESOTO SPINE CENTER, PLLC

Provider Business Mailing Address
First Line	:	1233 E PLEASANT RUN RD
Second Line	:	SUITE B
City	:	DESOTO
State	:	TX
Zip	:	75115-4200
Country	:	US
Telephone Number	:	469-567-8242
Fax Number	:	469-567-8290

Provider Business Practice Location Address
First Line	:	1233 E PLEASANT RUN RD
Second Line	:	SUITE B
City	:	DESOTO
State	:	TX
Zip	:	75115-4200
Country	:	US
Telephone Number	:	469-567-8242
Fax Number	:	469-567-8290

Authorized Official
Title or Position	:	OWNER
Name	:	DR. RAYMOND E. NEWSOME
Credential	:	D.C.
Telephone Number	:	469-567-8242

Provider Enumeration Date	:	10/20/2009
Last Update Date	:	10/20/2009

Similar Medicare Providers

1578666012 — CHARLES ARNOLD FOSTER II OD
Practice Location Address:

1233 E PLEASANT RUN RD
DESOTO, TX
75115-4200

Practice Phone: 972-223-2020
Practice Fax: 972-293-1860

1598810723 — DR. RAYMOND ELLIS NEWSOME D. C.
Practice Location Address:

1233 E PLEASANT RUN RD , B
DESOTO, TX
75115-4200

Practice Phone: 469-567-8242
Practice Fax: 469-567-8290

1851692040 — DR CHARLES A FOSTER
Practice Location Address:

1233 E PLEASANT RUN RD
DESOTO, TX
75115-4200

Practice Phone: 972-223-2020
Practice Fax: 972-228-1860

1720384498 — DR. DANIELLE R GLOSTER MORRIS O.D.
Practice Location Address:

1233 E PLEASANT RUN RD STE A
DESOTO, TX
75115-4200

Practice Phone: 972-223-2020
Practice Fax: 972-228-1860

1336601947 — FAMILY HEALTH & SPINAL REJUVENATION CLINIC LLC
Practice Location Address:

1233 E PLEASANT RUN RD STE B
DESOTO, TX
75115-4200

Practice Phone: 855-326-3644
Practice Fax:

1407472376 — OPTICAL BOUTIQUE AND EYECARE
Practice Location Address:

1233 E PLEASANT RUN RD STE A
DESOTO, TX
75115-4200

Practice Phone: 972-223-2020
Practice Fax: 972-228-1860

Directions to “DESOTO SPINE CENTER, PLLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.