Provider Demographics
NPI:1316012875
Name:SOUTH TEXAS ORTHOPAEDIC & SPINAL SURGERY ASSOCIATES P.A.
Entity Type:Organization
Organization Name:SOUTH TEXAS ORTHOPAEDIC & SPINAL SURGERY ASSOCIATES P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ARVO
Authorized Official - Middle Name:
Authorized Official - Last Name:NEIDRE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:210-561-7234
Mailing Address - Street 1:9150 HUEBNER RD
Mailing Address - Street 2:STE 350
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78240-1558
Mailing Address - Country:US
Mailing Address - Phone:210-561-7234
Mailing Address - Fax:210-561-7240
Practice Address - Street 1:9150 HUEBNER RD
Practice Address - Street 2:STE 350
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78240-1558
Practice Address - Country:US
Practice Address - Phone:210-561-7234
Practice Address - Fax:210-561-7240
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the SpineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00J04AMedicare ID - Type UnspecifiedMEDICARE GROUP NUMBER