Texoma Brain and Spine Surgery, PLLC

Primary specialty

Legal MedicineTaxonomy code 173000000X

License

14374 Issued in MS

Legal business name

TEXOMA BRAIN AND SPINE SURGERY, PLLC

Practice address

5012 S US Highway 75 Ste 220
Denison, TX 75020-4598

Phone

(903) 416-6460

Fax

(866) 291-0393

NPI assigned

Jun 2, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Michael C Molleston, MD

Title

Neurosurgeron

Phone

(601) 606-0979

Specialties & licenses 2

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1149206400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1471219200000",
    "number": "1831136217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5012 S US HIGHWAY 75 STE 220",
            "city": "DENISON",
            "state": "TX",
            "postal_code": "750204598",
            "telephone_number": "903-416-6460",
            "fax_number": "866-291-0393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5012 S US HIGHWAY 75 STE 220",
            "city": "DENISON",
            "state": "TX",
            "postal_code": "750204598",
            "telephone_number": "903-416-6460",
            "fax_number": "866-291-0393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TEXOMA BRAIN AND SPINE SURGERY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-02",
        "last_updated": "2016-08-15",
        "status": "A",
        "authorized_official_last_name": "MOLLESTON",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "NEUROSURGERON",
        "authorized_official_telephone_number": "601-606-0979",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "173000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Legal Medicine",
            "state": "MS",
            "license": "14374",
            "primary": true
        },
        {
            "code": "173000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Legal Medicine",
            "state": "MS",
            "license": "14374MS",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05783854",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Texas Foot and Ankle Consultants LLC
• Texas Senior Care, LP
• Texas Sitters LLC
• Texoma Allergy Group, PLLC
• Texoma Brain and Spine Surgery PLLC
• Texoma Emergency Physicians PLLC
• Texoma Foot and Ankle Specialists PA
• Texoma Heart Group, PA
• Texoma Interstate Ventures
• Texoma Kidney Care, P.a.

• Legal Medicine in Denison, TX
• Providers in Denison, TX by specialty
• Legal Medicine in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2016; 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.