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NPI Code Detail

MEDICARE: SPINE HEALTH AND WELLNESS, PLLC

MEDICARE: SPINE HEALTH AND WELLNESS, 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
1208100000XPhysical Medicine & Rehabilitation Physician

General Provider Information

NPI Number : 1891357026
Entity Type Code : Organization
Provider Name (Legal Business Name) : SPINE HEALTH AND WELLNESS, PLLC
Provider Business Mailing Address
First Line : 600 E JOHN CARPENTER FWY STE 125
Second Line :
City : IRVING
State : TX
Zip : 75062-4299
Country : US
Telephone Number : 972-556-5667
Fax Number :
Provider Business Practice Location Address
First Line : 600 E JOHN CARPENTER FWY STE 125
Second Line :
City : IRVING
State : TX
Zip : 75062-4299
Country : US
Telephone Number : 972-556-5667
Fax Number : 972-635-4430
Authorized Official
Title or Position : AUTHORIZED OFFICIAL
Name : GREGORY STOWE
Credential :
Telephone Number : 214-498-4866
Provider Enumeration Date : 07/09/2019
Last Update Date : 01/07/2022

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Directions to “SPINE HEALTH AND WELLNESS, PLLC ” Practice Location

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