Organization Active NPI

Dallas Spine Care PA

  • Medical Specialty Clinic/Center
  • Dallas, TX
National Provider Identifier
1730197286
Registry record updated Jul 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
Legal business name
DALLAS SPINE CARE PA
Practice address
9080 Harry Hines Blvd
Suite 210
Dallas, TX 75235-1720
Phone
(214) 688-0078
NPI assigned
Aug 3, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2012

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

Authorized official

Name
Robert J Henderson, M.D.
Title
Medical Director
Phone
(214) 688-0078

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Specialty Clinic/Center 261QM2500X Primary
Physician AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 363A00000X C1011 TX

Addresses

Primary practice location

9080 Harry Hines Blvd
Suite 210
Dallas, TX 75235-1720

Mailing address

7600 John W Carpenter Fwy
PMB #8
Dallas, TX 75247-4827
Phone (214) 688-0078

National Provider Directory

National Provider Directory

Locations

7600 John W Carpenter Fwy
Dallas, TX 75247

7600 John Carpenter Fwy
#P
Dallas, TX 75247

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1341878400000",
    "number": "1730197286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7600 JOHN W CARPENTER FWY",
            "address_2": "PMB #8",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752474827",
            "telephone_number": "214-688-0078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9080 HARRY HINES BLVD",
            "address_2": "SUITE 210",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752351720",
            "telephone_number": "214-688-0078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DALLAS SPINE CARE PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-03",
        "last_updated": "2012-07-10",
        "status": "A",
        "authorized_official_last_name": "HENDERSON",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "214-688-0078",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "C1011",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2012; 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.