Elite Spine Services PLLC

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

Legal business name

ELITE SPINE SERVICES PLLC

Practice address

700 E Marshall Ave
Longview, TX 75601-5580

Phone

(817) 756-8236

NPI assigned

Jan 11, 2021

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Rekha Wagle

Title

Npi Administrator

Phone

(817) 756-8232

Specialties & licenses 1

Addresses

Electronic endpoints 2

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1610323200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611532800000",
    "number": "1023607454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2140 HALL JOHNSON RD, 102 # 128",
            "city": "GRAPEVINE",
            "state": "TX",
            "postal_code": "760518753",
            "telephone_number": "817-756-8232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 E MARSHALL AVE",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756015580",
            "telephone_number": "817-756-8236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE SPINE SERVICES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-11",
        "last_updated": "2021-01-25",
        "certification_date": "2021-01-25",
        "status": "A",
        "authorized_official_last_name": "WAGLE",
        "authorized_official_first_name": "REKHA",
        "authorized_official_title_or_position": "NPI ADMINISTRATOR",
        "authorized_official_telephone_number": "817-756-8232"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rwagle@surgicalserv.com",
            "affiliation": "N",
            "endpointDescription": "Email",
            "address_1": "2000 E LaMar Blvd",
            "city": "Arlington",
            "state": "TX",
            "country_code": "US",
            "postal_code": "760067346",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rwagle@surgicalserv.com",
            "affiliation": "N",
            "endpointDescription": "Email",
            "address_1": "2000 E LaMar Blvd",
            "city": "Arlington",
            "state": "TX",
            "country_code": "US",
            "postal_code": "760067346",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Ahmed A Elbira, DDS
• Elder Chiropractic Clinic
• Jack D Elder, MD
• Elevate Healthcare - Longview LLC
• Baher M Elhalwagi, MD
• Elizabeth Breedlove Family Practice & Aesthetics
• Ross-Jordon Elliott, M.D.
• Mandy Elswick
• Ifeanyi Emmanuel Elueze, MD PHD
• Aubren Martin Emberton, PHARMD

• Surgical Physician Assistant in Longview, TX
• Providers in Longview, TX by specialty
• Surgical Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.