Provider Demographics
NPI:1164873964
Name:SPINAL PARTNERS OF TEXAS
Entity Type:Organization
Organization Name:SPINAL PARTNERS OF TEXAS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:MR
Authorized Official - First Name:TREY
Authorized Official - Middle Name:
Authorized Official - Last Name:TROSCLAIR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-463-6309
Mailing Address - Street 1:PO BOX 541911
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77254-1911
Mailing Address - Country:US
Mailing Address - Phone:281-463-6309
Mailing Address - Fax:281-463-6835
Practice Address - Street 1:24530 KINGSLAND BLVD
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494-3429
Practice Address - Country:US
Practice Address - Phone:281-463-6309
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-23
Last Update Date:2016-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgicalGroup - Single Specialty