Provider Demographics
NPI:1568914943
Name:EBCMD PLLC
Entity Type:Organization
Organization Name:EBCMD PLLC
Other - Org Name:TEXAS JOINT AND SPINE CENTERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:
Authorized Official - Last Name:BOHNENBLUST
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:469-334-0624
Mailing Address - Street 1:411 N WASHINGTON AVE STE 2600
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75246-1713
Mailing Address - Country:US
Mailing Address - Phone:469-334-0624
Mailing Address - Fax:214-269-7547
Practice Address - Street 1:411 N WASHINGTON AVE STE 2600
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75246-1713
Practice Address - Country:US
Practice Address - Phone:469-334-0624
Practice Address - Fax:214-269-7547
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-01
Last Update Date:2020-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty