Provider Demographics
NPI:1144407032
Name:ORTHOPAEDIC INSTITUTE FOR SPINAL DISORDERS, P.A
Entity Type:Organization
Organization Name:ORTHOPAEDIC INSTITUTE FOR SPINAL DISORDERS, P.A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPINAL SURGERY SPECIALIST
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:E
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-781-5676
Mailing Address - Street 1:2500 FONDREN RD STE 210
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77063-2313
Mailing Address - Country:US
Mailing Address - Phone:713-781-5676
Mailing Address - Fax:713-781-5712
Practice Address - Street 1:2500 FONDREN RD STE 210
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77063-2313
Practice Address - Country:US
Practice Address - Phone:713-781-5676
Practice Address - Fax:713-781-5712
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-23
Last Update Date:2022-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH6934207XS0117X
207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the SpineGroup - Single Specialty