Provider Demographics
NPI:1083250914
Name:WEST TEXAS SPINE INSTITUTE, PLLC
Entity Type:Organization
Organization Name:WEST TEXAS SPINE INSTITUTE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:REECE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:850-293-6742
Mailing Address - Street 1:4400 STATE HIGHWAY 121 STE 405
Mailing Address - Street 2:
Mailing Address - City:LEWISVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75056-4561
Mailing Address - Country:US
Mailing Address - Phone:432-231-4911
Mailing Address - Fax:
Practice Address - Street 1:500 E 4TH ST
Practice Address - Street 2:
Practice Address - City:ODESSA
Practice Address - State:TX
Practice Address - Zip Code:79761-5110
Practice Address - Country:US
Practice Address - Phone:432-231-4911
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-26
Last Update Date:2021-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty