Organization Active NPI

Axis Brain and Back Institute PLLC

  • Durable Medical Equipment & Medical Supplies
  • Southlake, TX
National Provider Identifier
1295641736
Registry record updated Aug 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
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 PLLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 25, 2026

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)CodeLicenseStatePrimary
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.

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.

Verify at the official NPI Registry.