Provider Demographics
NPI:1851850291
Name:SPINEMD PLLC
Entity Type:Organization
Organization Name:SPINEMD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ANIL
Authorized Official - Middle Name:KUMAR
Authorized Official - Last Name:KESANI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-893-6001
Mailing Address - Street 1:7500 DAVIS BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:NORTH RICHLAND HILLS
Mailing Address - State:TX
Mailing Address - Zip Code:76182-7402
Mailing Address - Country:US
Mailing Address - Phone:817-893-6001
Mailing Address - Fax:855-248-1291
Practice Address - Street 1:7500 DAVIS BLVD STE 100
Practice Address - Street 2:
Practice Address - City:NORTH RICHLAND HILLS
Practice Address - State:TX
Practice Address - Zip Code:76182-7402
Practice Address - Country:US
Practice Address - Phone:817-893-6001
Practice Address - Fax:855-248-1291
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-15
Last Update Date:2020-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the SpineGroup - Single Specialty
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty