Provider Demographics
NPI:1609289867
Name:TEXAS ORTHOPAEDIC & SPORTS MEDICINE
Entity Type:Organization
Organization Name:TEXAS ORTHOPAEDIC & SPORTS MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:SUBLETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-803-3246
Mailing Address - Street 1:9319 PINECROFT
Mailing Address - Street 2:200
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77380-3485
Mailing Address - Country:US
Mailing Address - Phone:281-465-1060
Mailing Address - Fax:281-465-1086
Practice Address - Street 1:9319 PINECROFT
Practice Address - Street 2:200
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77380-3485
Practice Address - Country:US
Practice Address - Phone:281-465-1060
Practice Address - Fax:281-465-1086
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-05
Last Update Date:2021-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
0995950002Medicare NSC