Provider Demographics
NPI:1831410323
Name:REPUBLIC SPINE AND PAIN, P.A.
Entity type:Organization
Organization Name:REPUBLIC SPINE AND PAIN, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CLEMENT
Authorized Official - Middle Name:
Authorized Official - Last Name:YEH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:512-219-8787
Mailing Address - Street 1:13617 CALDWELL DR STE 100
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78750-2324
Mailing Address - Country:US
Mailing Address - Phone:512-219-8787
Mailing Address - Fax:512-219-8788
Practice Address - Street 1:13617 CALDWELL DR STE 100
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78750-2324
Practice Address - Country:US
Practice Address - Phone:512-219-8787
Practice Address - Fax:512-219-8788
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-18
Last Update Date:2023-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Multi-Specialty
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty