Provider Demographics
NPI:1114375482
Name:SPINE CARE & PAIN MANAGEMENT OF SAN ANTONIO LLC
Entity Type:Organization
Organization Name:SPINE CARE & PAIN MANAGEMENT OF SAN ANTONIO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:S
Authorized Official - Last Name:MCKEE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:210-545-0087
Mailing Address - Street 1:20079 STONE OAK PKWY
Mailing Address - Street 2:SUITE 1245
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258-6957
Mailing Address - Country:US
Mailing Address - Phone:210-545-0087
Mailing Address - Fax:210-545-3455
Practice Address - Street 1:20079 STONE OAK PKWY
Practice Address - Street 2:SUITE 1245
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-6957
Practice Address - Country:US
Practice Address - Phone:210-545-0087
Practice Address - Fax:210-545-3455
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-27
Last Update Date:2016-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL5046208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Multi-Specialty