Provider Demographics
NPI:1376095414
Name:TEXAS SPINE AND WELLNESS, LLC
Entity Type:Organization
Organization Name:TEXAS SPINE AND WELLNESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ASHER
Authorized Official - Middle Name:
Authorized Official - Last Name:KURESHY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-592-0469
Mailing Address - Street 1:1223 W MCDERMOTT DR
Mailing Address - Street 2:#70
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75013-6412
Mailing Address - Country:US
Mailing Address - Phone:214-592-0469
Mailing Address - Fax:972-212-7185
Practice Address - Street 1:1223 W MCDERMOTT DR
Practice Address - Street 2:#70
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75013-6412
Practice Address - Country:US
Practice Address - Phone:214-592-0469
Practice Address - Fax:972-212-7185
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-25
Last Update Date:2016-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty