Provider Demographics
NPI:1558013169
Name:TEXAS ORTHOPEDIC AND SPINE ASSOCIATES PLLC
Entity Type:Organization
Organization Name:TEXAS ORTHOPEDIC AND SPINE ASSOCIATES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TATIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:BOYKO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:408-966-0097
Mailing Address - Street 1:923 COLLEGE AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76104-3051
Mailing Address - Country:US
Mailing Address - Phone:817-697-4038
Mailing Address - Fax:877-409-3962
Practice Address - Street 1:923 COLLEGE AVE STE 101
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76104-3051
Practice Address - Country:US
Practice Address - Phone:817-697-4038
Practice Address - Fax:877-409-3962
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-25
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0105XAllopathic & Osteopathic PhysiciansSurgerySurgery of the HandGroup - Multi-Specialty
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
No207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the SpineGroup - Multi-Specialty
No208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Multi-Specialty