Provider Demographics
NPI:1033772173
Name:TEXAS SPINE AND ORTHOPEDIC SOLUTIONS
Entity Type:Organization
Organization Name:TEXAS SPINE AND ORTHOPEDIC SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:NITIN
Authorized Official - Middle Name:
Authorized Official - Last Name:KUKKAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:217-819-6586
Mailing Address - Street 1:1806 AYLETH AVE
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78213-3975
Mailing Address - Country:US
Mailing Address - Phone:210-401-1515
Mailing Address - Fax:210-401-1818
Practice Address - Street 1:1002 E BLANCO RD STE B
Practice Address - Street 2:
Practice Address - City:BOERNE
Practice Address - State:TX
Practice Address - Zip Code:78006-1802
Practice Address - Country:US
Practice Address - Phone:210-401-1515
Practice Address - Fax:210-401-1818
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-15
Last Update Date:2022-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty