Brain and Spine Center of Southeast Texas, PLLC

Primary specialty

Neurological Surgery PhysicianTaxonomy code 207T00000X

Legal business name

BRAIN AND SPINE CENTER OF SOUTHEAST TEXAS, PLLC

Doing business as

Spine Tech

Practice address

755 S 11TH St Ste 102
Beaumont, TX 77701-3723

Phone

(409) 234-7088

Fax

(409) 892-8237

NPI assigned

Aug 14, 2013

Last updated

Oct 16, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Erwin Lo, MDNPI 1760482640

Title

Owner

Phone

(409) 234-7088

Specialties & licenses 3

Addresses

Other names 1

• SPINE TECH Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Erwin Lo, MD

  • Specialist
  • Beaumont, TX
  • NPI 1760482640
  Medicare reassignment Care Compare group NPD Authorized official
• Hassan Chahadeh, MD PA

  • Interventional Pain Medicine Physician
  • Houston, TX
  • NPI 1730124470
  Medicare reassignment Care Compare group NPD
• Arshad A Khan, DPM

  • Foot & Ankle Surgery Podiatrist
  • Beaumont, TX
  • NPI 1114977907
  Medicare reassignment Care Compare group NPD
• Sujin Yu, MD

  • Specialist
  • Beaumont, TX
  • NPI 1710987672
  Medicare reassignment Care Compare group NPD
• Jihoon Choi, MD

  • Orthopaedic Surgery of the Spine Physician
  • Rockwall, TX
  • NPI 1285097741
  Medicare reassignment NPD
• Don Auffurth Duplan, MD

  • Otolaryngology Physician
  • Port Arthur, TX
  • NPI 1598763062
  Medicare reassignment NPD

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

{
    "created_epoch": "1376438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729036800000",
    "number": "1265865158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "755 S 11TH ST STE 102",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777013723",
            "telephone_number": "409-234-7088",
            "fax_number": "409-892-8237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "755 S 11TH ST STE 102",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777013723",
            "telephone_number": "409-234-7088",
            "fax_number": "409-892-8237"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2400 FM 365",
            "address_2": "Suite 104",
            "address_purpose": "LOCATION",
            "city": "Nederland",
            "state": "TX",
            "postal_code": "77627",
            "country_code": "US",
            "telephone_number": "409-554-0545",
            "fax_number": "844-965-9044",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "204 N 1st St",
            "address_purpose": "LOCATION",
            "city": "Conroe",
            "state": "TX",
            "postal_code": "773012920",
            "country_code": "US",
            "telephone_number": "936-756-2415",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "87 Ih 10 N Ste 221",
            "address_purpose": "LOCATION",
            "city": "Beaumont",
            "state": "TX",
            "postal_code": "777072562",
            "country_code": "US",
            "telephone_number": "409-554-0545",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "111 Vision Park Blvd Ste 245",
            "address_purpose": "LOCATION",
            "city": "Shenandoah",
            "state": "TX",
            "postal_code": "773843016",
            "country_code": "US",
            "telephone_number": "936-647-0202",
            "fax_number": "409-898-0177",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "BRAIN AND SPINE CENTER OF SOUTHEAST TEXAS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-14",
        "last_updated": "2024-10-16",
        "certification_date": "2024-10-16",
        "status": "A",
        "authorized_official_last_name": "LO",
        "authorized_official_first_name": "ERWIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "409-234-7088",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Neurological Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SPINE TECH",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Wallace Earl Bradford, PHARMACIST
• Amanda Bradley
• Justin Bradley
• Kristen Bradley, APRN, AGACNP-BC,RNFA
• Alfred B. Brady Jr., M.D.
• Martha Ortega Brands, O.D.
• Paris Patrick Bransford, MD
• Roxanne Elizabeth Braswell, R.PH.
• Amy Breaux
• Brittany Nicole Breaux, LVN

• Neurological Surgery Physician in Beaumont, TX
• Providers in Beaumont, TX by specialty
• Neurological Surgery Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2024; 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.