NPIMap

Organization Active NPI

Spine Team Texas, PA

  • Specialist
  • Rockwall, TX
National Provider Identifier
1609009505
Registry record updated Jun 25, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
SPINE TEAM TEXAS, PA
Practice address
3142 Horizon Rd
Suite 100
Rockwall, TX 75032-7809
Phone
(817) 442-9300
Fax
(817) 796-0763
NPI assigned
Aug 26, 2009
Last updated
Jun 25, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2014

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

Authorized official

Name
Mark Hood
Title
Ceo
Phone
(817) 442-9300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

3142 Horizon Rd
Suite 100
Rockwall, TX 75032-7809

Mailing address

1545 E Southlake Blvd
Suite 100
Southlake, TX 76092-6422
Phone (817) 442-9300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051230000616 TX Part B Supplier - Clinic/Group Practice 6507888757 Receives reassigned benefits from 132 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Fort Worth, TX; Rockwall, TX; Southlake, TX

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

3142 Horizon Rd
Ste 100
Rockwall, TX 75032
Phone (682) 651-1908

Practitioners & affiliated clinicians

Practitioners 43

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.

View all 43

NPI Registry JSON

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

{
    "created_epoch": "1251244800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1403654400000",
    "number": "1609009505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1545 E SOUTHLAKE BLVD",
            "address_2": "SUITE 100",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760926422",
            "telephone_number": "817-442-9300",
            "fax_number": "817-796-0763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3142 HORIZON RD",
            "address_2": "SUITE 100",
            "city": "ROCKWALL",
            "state": "TX",
            "postal_code": "750327809",
            "telephone_number": "817-442-9300",
            "fax_number": "817-796-0763"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPINE TEAM TEXAS, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-26",
        "last_updated": "2014-06-25",
        "status": "A",
        "authorized_official_last_name": "HOOD",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "817-442-9300"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockwall, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2014; 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.