Provider Demographics
NPI:1023343134
Name:SOUTHWEST SCOLIOSIS INSTITUTE, PLLC
Entity type:Organization
Organization Name:SOUTHWEST SCOLIOSIS INSTITUTE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:HOSTIN
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:972-985-2797
Mailing Address - Street 1:4708 ALLIANCE BLVD
Mailing Address - Street 2:SUITE 810
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-5340
Mailing Address - Country:US
Mailing Address - Phone:972-985-2797
Mailing Address - Fax:972-985-4797
Practice Address - Street 1:4708 ALLIANCE BLVD
Practice Address - Street 2:SUITE 810
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-5340
Practice Address - Country:US
Practice Address - Phone:972-985-2797
Practice Address - Fax:972-985-4797
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-07
Last Update Date:2010-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the SpineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX6402910001Medicare NSC