Provider Demographics
NPI:1881070480
Name:SPINE & ORTHOPEDIC SURGICAL INSTITUTE, PLLC
Entity type:Organization
Organization Name:SPINE & ORTHOPEDIC SURGICAL INSTITUTE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:LAM
Authorized Official - Last Name:LE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:346-980-8700
Mailing Address - Street 1:9000 SOUTHWEST FWY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77074-1529
Mailing Address - Country:US
Mailing Address - Phone:346-980-8700
Mailing Address - Fax:346-980-8701
Practice Address - Street 1:9000 SOUTHWEST FWY
Practice Address - Street 2:SUITE 200
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77074-1529
Practice Address - Country:US
Practice Address - Phone:346-980-8700
Practice Address - Fax:346-980-8701
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-05
Last Update Date:2015-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN3819261QM1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty