Texas Spine and Joint Hospital, LLC

Organization Active NPI Urgent Care Clinic/Center · Tyler, TX

NPI 1780121210 · NPPES record last updated Oct 22, 2020

Key facts

NPI
1780121210
Entity type
Organization (NPI type 2)
Primary specialty
Urgent Care Clinic/Center 261QU0200X
Legal business name
TEXAS SPINE AND JOINT HOSPITAL, LLC
Practice address
8101 S Broadway Ave
Tyler, TX 75703-5469
Phone
(903) 939-0920
NPI assigned
Jan 23, 2017
Organization subpart
No

Authorized official

Name
Tony Wahl
Title
Officer / Authorized Official
Phone
(903) 525-3300

Corporate family (same tax ID) 2

Organizations that report the same tax identification number in the National Provider Directory.

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D2049967Baylor Scott & White Texas Spine & Joint Hospital
8101 South Broadway Ave, Tyler, TX 75703
Certificate of waiverNov 15, 2026

National Provider Directory

Tax ID family
Texas Spine and Joint Hospital LLC (3 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X Yes

Addresses

Primary practice location

8101 S Broadway Ave
Tyler, TX 75703-5469

Mailing address

1814 Roseland Blvd
Tyler, TX 75701-4234
Phone (903) 525-3330

Other identifiers

IdentifierTypeStateIssuer
162459501MedicaidTX

Other names

  • Baylor Scott & White TX Spine & Joint Hosp Urgent Care Doing business as

Other providers in Tyler, TX

All providers in Tyler, TX · Urgent Care Clinic/Center in Texas

Sources for this page

Verify at the official NPI Registry.