Provider Demographics
NPI:1710527932
Name:HOUSTON SCOLIOSIS & SPINE INSTITUTE, LLC
Entity Type:Organization
Organization Name:HOUSTON SCOLIOSIS & SPINE INSTITUTE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RA'KERRY
Authorized Official - Middle Name:KAHLIL
Authorized Official - Last Name:RAHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:646-422-9498
Mailing Address - Street 1:7700 MAIN ST STE 400
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-4456
Mailing Address - Country:US
Mailing Address - Phone:346-250-2590
Mailing Address - Fax:281-836-4453
Practice Address - Street 1:7700 MAIN ST STE 400
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-4456
Practice Address - Country:US
Practice Address - Phone:346-250-2590
Practice Address - Fax:281-836-4453
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-15
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXFR6577336OtherDEA