Provider Demographics
NPI:1356639678
Name:BRAIN AND SPINE CENTER PLC
Entity Type:Organization
Organization Name:BRAIN AND SPINE CENTER PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:HEMANT
Authorized Official - Middle Name:K
Authorized Official - Last Name:PANDEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:480-917-3706
Mailing Address - Street 1:4045 W CHANDLER BLVD BLDG F
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85226-3732
Mailing Address - Country:US
Mailing Address - Phone:480-917-3706
Mailing Address - Fax:480-353-2066
Practice Address - Street 1:1760 E FLORENCE BLVD STE 250
Practice Address - Street 2:
Practice Address - City:CASA GRANDE
Practice Address - State:AZ
Practice Address - Zip Code:85122-4769
Practice Address - Country:US
Practice Address - Phone:480-917-3706
Practice Address - Fax:480-353-2066
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-20
Last Update Date:2023-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ147508Medicare PIN