Provider Demographics
NPI:1104039338
Name:TEXAS ORTHOPEDIC & SPINE ASSOCIATES
Entity Type:Organization
Organization Name:TEXAS ORTHOPEDIC & SPINE ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING
Authorized Official - Prefix:MS
Authorized Official - First Name:CATHY
Authorized Official - Middle Name:
Authorized Official - Last Name:HUNT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-571-9099
Mailing Address - Street 1:2008 L DON DODSON DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:BEDFORD
Mailing Address - State:TX
Mailing Address - Zip Code:76021-5788
Mailing Address - Country:US
Mailing Address - Phone:817-571-9099
Mailing Address - Fax:817-571-5282
Practice Address - Street 1:2008 L DON DODSON DR
Practice Address - Street 2:SUITE 100
Practice Address - City:BEDFORD
Practice Address - State:TX
Practice Address - Zip Code:76021-5788
Practice Address - Country:US
Practice Address - Phone:817-571-9099
Practice Address - Fax:817-571-5282
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK1579174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty