MEDICARE: SPINE VUE, 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	207X00000X	Orthopaedic Surgery Physician	P3361	TX

General Provider Information

NPI Number	:	1790109734
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SPINE VUE, PLLC

Provider Business Mailing Address
First Line	:	8440 WALNUT HILL LN STE 230
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75231-3816
Country	:	US
Telephone Number	:	214-452-7705
Fax Number	:	214-377-8831

Provider Business Practice Location Address
First Line	:	8440 WALNUT HILL LN STE 230
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75231-3816
Country	:	US
Telephone Number	:	214-452-7705
Fax Number	:	214-377-8831

Authorized Official
Title or Position	:	OWNER
Name	:	DR. SEAN MAWUSI JONES-QUAIDOO
Credential	:
Telephone Number	:	214-452-7705

Provider Enumeration Date	:	02/11/2014
Last Update Date	:	01/06/2022

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Directions to “SPINE VUE, PLLC ” Practice Location

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