Provider Demographics
NPI:1083634299
Name:TEXAS SPINE INSTITUTE, LLP
Entity Type:Organization
Organization Name:TEXAS SPINE INSTITUTE, LLP
Other - Org Name:TEXAS REHABILITATION SOLUTIONS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPERATING PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SUNJAY
Authorized Official - Middle Name:
Authorized Official - Last Name:WAGLE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:469-727-7246
Mailing Address - Street 1:PO BOX 2028
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034
Mailing Address - Country:US
Mailing Address - Phone:469-727-7246
Mailing Address - Fax:469-727-7833
Practice Address - Street 1:951 YORK DR
Practice Address - Street 2:SUITE 103
Practice Address - City:DESOTO
Practice Address - State:TX
Practice Address - Zip Code:75115-2052
Practice Address - Country:US
Practice Address - Phone:469-727-7246
Practice Address - Fax:469-727-7833
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TEXAS SPINE INSTITUTE, LLP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-07-20
Last Update Date:2012-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty