Provider Demographics
NPI:1982005823
Name:TEXAS INSTITUTE FOR SPINE CARE
Entity Type:Organization
Organization Name:TEXAS INSTITUTE FOR SPINE CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:NILESH
Authorized Official - Middle Name:
Authorized Official - Last Name:KOTECHA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:734-709-6477
Mailing Address - Street 1:7 TIOGA PL
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77375-4865
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7 TIOGA PL
Practice Address - Street 2:
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77375-4865
Practice Address - Country:US
Practice Address - Phone:734-709-6477
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-10
Last Update Date:2014-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171R00000XOther Service ProvidersInterpreterGroup - Single Specialty