Active NPI
Axis Brain and Back Institute PLLC
- Durable Medical Equipment & Medical Supplies
- Southlake, TX
National Provider Identifier
1295641736
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Durable Medical Equipment & Medical Supplies
- Legal business name
- AXIS BRAIN AND BACK INSTITUTE PLLC
- Practice address
- 1110 E State Highway 114 Ste 100
Southlake, TX 76092-5251 - Phone
- (817) 502-7411
- Fax
- (817) 502-7412
- NPI assigned
- Aug 24, 2026
- Organization subpart
- Yes
- Parent organization
- AXIS BRAIN AND BACK INSTITUTE PLLC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ms. Amber Marie Marty
- Title
- Practice Administrator
- Phone
- (817) 502-7411
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | Primary |
Addresses
Primary practice location
1110 E State Highway 114 Ste 100
Southlake, TX 76092-5251
Mailing address
1110 E State Highway 114 Ste 100
Southlake, TX 76092-5251
Phone (817) 502-7411
Ownership & related parties
Parent organization (reported in NPPES) 1
This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.
-
- Neurological Surgery Physician
- Southlake, TX
- NPI 1689085193
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1787529600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1787616000000",
"number": "1295641736",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1110 E STATE HIGHWAY 114 STE 100",
"city": "SOUTHLAKE",
"state": "TX",
"postal_code": "760925251",
"telephone_number": "817-502-7411",
"fax_number": "817-502-7412"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1110 E STATE HIGHWAY 114 STE 100",
"city": "SOUTHLAKE",
"state": "TX",
"postal_code": "760925251",
"telephone_number": "817-502-7411",
"fax_number": "817-502-7412"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "AXIS BRAIN AND BACK INSTITUTE PLLC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "AXIS BRAIN AND BACK INSTITUTE PLLC",
"enumeration_date": "2026-08-24",
"last_updated": "2026-08-25",
"certification_date": "2026-08-25",
"status": "A",
"authorized_official_last_name": "MARTY",
"authorized_official_first_name": "AMBER",
"authorized_official_middle_name": "MARIE",
"authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
"authorized_official_telephone_number": "817-502-7411",
"authorized_official_name_prefix": "Ms."
},
"taxonomies": [
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Southlake, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.