Provider Demographics
NPI:1093428633
Name:RESTORATIVE SPINE AND BRAIN CENTER OF DALLAS PLLC
Entity Type:Organization
Organization Name:RESTORATIVE SPINE AND BRAIN CENTER OF DALLAS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SONIA
Authorized Official - Middle Name:
Authorized Official - Last Name:TEACH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-535-2170
Mailing Address - Street 1:5425 W SPRING CREEK PKWY STE 133
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75024-4334
Mailing Address - Country:US
Mailing Address - Phone:972-535-2170
Mailing Address - Fax:972-535-2181
Practice Address - Street 1:5425 W SPRING CREEK PKWY STE 133
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75024-4334
Practice Address - Country:US
Practice Address - Phone:972-535-2170
Practice Address - Fax:972-535-2181
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-28
Last Update Date:2023-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Single Specialty