Provider Demographics
NPI:1912941758
Name:RECONSTRUCTIVE ORTHOPAEDIC SURGEONS P.A.
Entity Type:Organization
Organization Name:RECONSTRUCTIVE ORTHOPAEDIC SURGEONS P.A.
Other - Org Name:TEXAS CENTER FOR JOINT REPLACEMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROGER
Authorized Official - Middle Name:H
Authorized Official - Last Name:EMERSON
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:972-608-8868
Mailing Address - Street 1:6020 W PARKER RD
Mailing Address - Street 2:STE 470
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-8171
Mailing Address - Country:US
Mailing Address - Phone:972-608-8868
Mailing Address - Fax:972-608-0366
Practice Address - Street 1:6020 W PARKER RD
Practice Address - Street 2:STE 470
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-8171
Practice Address - Country:US
Practice Address - Phone:972-608-8868
Practice Address - Fax:972-608-0366
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-15
Last Update Date:2010-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XS0114XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryAdult Reconstructive Orthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX082314801Medicaid
TX082314801Medicaid