Spine Texas & Neurological Surgery

Primary specialty

Neurological Surgery PhysicianTaxonomy code 207T00000X

Legal business name

SPINE TEXAS & NEUROLOGICAL SURGERY

Practice address

111 Vision Park Blvd
220
Shenandoah, TX 77384-3002

Phone

(888) 678-4704

Fax

(888) 393-8970

NPI assigned

Jul 10, 2014

Organization subpart

No

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

Authorized official

Name

Elias Dagnew, MD

Title

President

Phone

(888) 678-4704

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1404950400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1404950400000",
    "number": "1376959247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 VISION PARK BLVD",
            "address_2": "220",
            "city": "SHENANDOAH",
            "state": "TX",
            "postal_code": "773843002",
            "telephone_number": "888-678-4704",
            "fax_number": "888-393-8970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 VISION PARK BLVD",
            "address_2": "220",
            "city": "SHENANDOAH",
            "state": "TX",
            "postal_code": "773843002",
            "telephone_number": "888-678-4704",
            "fax_number": "888-393-8970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPINE TEXAS & NEUROLOGICAL SURGERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-10",
        "last_updated": "2014-07-10",
        "status": "A",
        "authorized_official_last_name": "DAGNEW",
        "authorized_official_first_name": "ELIAS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "888-678-4704",
        "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": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2014; 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.