Organization Active NPI

Longhorn Brain and Spine PLLC

  • Neurological Surgery Physician
  • Fort Worth, TX
National Provider Identifier
1053996447
Registry record updated Mar 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
Legal business name
LONGHORN BRAIN AND SPINE PLLC
Practice address
1001 12TH Ave Ste 168
Fort Worth, TX 76104-3947
Phone
(682) 337-7463
Fax
(682) 337-7464
NPI assigned
Mar 16, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2025

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

Authorized official

Name
Grant Allen Booher, MDNPI 1982963591
Title
President
Phone
(682) 337-7463

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207T00000X Primary

Addresses

Primary practice location

1001 12TH Ave Ste 168
Fort Worth, TX 76104-3947

Mailing address

PO Box 185
Fort Worth, TX 76101-0185
Phone (682) 337-7463

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20210406000164 TX Part B Supplier - Clinic/Group Practice 8426465667 Receives reassigned benefits from 2 practitioners
Practice locations: Fort Worth, TX
O20240213001474 TX DME Supplier - Physician - Neurosurgery 8426465667 Practice locations: Fort Worth, TX

National Provider Directory

National Provider Directory

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

1001 12th Ave
Ste 168
Ft Worth, TX 76104
Phone (682) 337-7463

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/AFFFCD

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1615852800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1742428800000",
    "number": "1053996447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 185",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761010185",
            "telephone_number": "682-337-7463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 12TH AVE STE 168",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761043947",
            "telephone_number": "682-337-7463",
            "fax_number": "682-337-7464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LONGHORN BRAIN AND SPINE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-16",
        "last_updated": "2025-03-20",
        "certification_date": "2025-03-20",
        "status": "A",
        "authorized_official_last_name": "BOOHER",
        "authorized_official_first_name": "GRANT",
        "authorized_official_middle_name": "ALLEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "682-337-7463",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Neurological Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.