Provider Demographics
NPI:1811315195
Name:NEXT GENERATION ORTHOPEDIC & SPINE INSTITUTE NEXTGEN ORTHOPEDIC
Entity type:Organization
Organization Name:NEXT GENERATION ORTHOPEDIC & SPINE INSTITUTE NEXTGEN ORTHOPEDIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:
Authorized Official - Last Name:OWUSU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:856-524-0823
Mailing Address - Street 1:13409 NW MILITARY HWY STE 211
Mailing Address - Street 2:
Mailing Address - City:SHAVANO PARK
Mailing Address - State:TX
Mailing Address - Zip Code:78231-1865
Mailing Address - Country:US
Mailing Address - Phone:210-251-2010
Mailing Address - Fax:210-855-7337
Practice Address - Street 1:13409 NW MILITARY HWY STE 211
Practice Address - Street 2:
Practice Address - City:SHAVANO PARK
Practice Address - State:TX
Practice Address - Zip Code:78231-1865
Practice Address - Country:US
Practice Address - Phone:210-251-2010
Practice Address - Fax:210-855-7337
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-02
Last Update Date:2017-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP6882207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the SpineGroup - Single Specialty