Provider Demographics
NPI:1255806048
Name:GBS SPINAL ASSOCIATES LLC
Entity type:Organization
Organization Name:GBS SPINAL ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RCM DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:FRAN
Authorized Official - Middle Name:
Authorized Official - Last Name:PEDANO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:574-204-2859
Mailing Address - Street 1:11750 KATY FWY STE 1100
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77079-1257
Mailing Address - Country:US
Mailing Address - Phone:574-204-2859
Mailing Address - Fax:609-925-9007
Practice Address - Street 1:9301 CONNECTICUT DR
Practice Address - Street 2:
Practice Address - City:CROWN POINT
Practice Address - State:IN
Practice Address - Zip Code:46307-7486
Practice Address - Country:US
Practice Address - Phone:574-314-5023
Practice Address - Fax:609-925-9007
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-08
Last Update Date:2018-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the SpineGroup - Single Specialty