Provider Demographics
NPI:1912142480
Name:TEXAS SPINE CLINIC PA
Entity Type:Organization
Organization Name:TEXAS SPINE CLINIC PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:DR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:S
Authorized Official - Last Name:BARTON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:210-545-5111
Mailing Address - Street 1:3212 NAPIER PARK
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78231-1522
Mailing Address - Country:US
Mailing Address - Phone:210-545-5111
Mailing Address - Fax:210-545-5120
Practice Address - Street 1:3212 NAPIER PARK
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78231-1522
Practice Address - Country:US
Practice Address - Phone:210-545-5111
Practice Address - Fax:210-545-5120
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-11
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9594111N00000X
TX10729111N00000X
208100000X, 208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0098RXOtherBCBS
TX613115Medicare PIN