Provider Demographics
NPI:1750877767
Name:SPINALWORKS MEDICAL GROUP, PLLC
Entity type:Organization
Organization Name:SPINALWORKS MEDICAL GROUP, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:CARTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-296-0269
Mailing Address - Street 1:2821 ROUTH ST
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75201-1414
Mailing Address - Country:US
Mailing Address - Phone:214-296-0269
Mailing Address - Fax:469-212-1188
Practice Address - Street 1:2821 ROUTH ST
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75201-1414
Practice Address - Country:US
Practice Address - Phone:214-296-0269
Practice Address - Fax:469-212-1188
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-03
Last Update Date:2018-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty