Provider Demographics
NPI:1871748384
Name:TEXAS SPINE CONSULTANTS, LLP
Entity type:Organization
Organization Name:TEXAS SPINE CONSULTANTS, LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:CODIE
Authorized Official - Middle Name:
Authorized Official - Last Name:LUNT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-370-3535
Mailing Address - Street 1:17051 DALLAS PKWY
Mailing Address - Street 2:SUITE 400
Mailing Address - City:ADDISON
Mailing Address - State:TX
Mailing Address - Zip Code:75001-7101
Mailing Address - Country:US
Mailing Address - Phone:214-370-3535
Mailing Address - Fax:214-370-0004
Practice Address - Street 1:17051 DALLAS PKWY
Practice Address - Street 2:SUITE 400
Practice Address - City:ADDISON
Practice Address - State:TX
Practice Address - Zip Code:75001-7101
Practice Address - Country:US
Practice Address - Phone:214-370-3535
Practice Address - Fax:214-370-0004
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-25
Last Update Date:2022-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the SpineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXD06621OtherRAIL ROAD MEDICARE PIN
TX156785101Medicaid
TX0066RXOtherBCBS PIN
TX156785102Medicaid
TXD06621OtherRAIL ROAD MEDICARE PIN