# SPINE & ORTHOPEDIC INSTITUTE, PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1043798077
- **Authorized official:** DR. DOUGLAS WON MD (SURGEON)
- **Authorized official phone:** (972) 399-9012

## Contact information

- **Practice address:** 4301 N MACARTHUR BLVD STE 100, IRVING, TX 75038-6497
- **Practice address phone:** (972) 399-9012
- **Mailing address:** 18208 PRESTON RD, D-9 \#355, DALLAS, TX 75252
- **Mailing address phone:** (972) 399-9012

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | L9018 | TX | — |
| 207XS0117X | Orthopaedic Surgery of the Spine Physician | L9018 | TX | — |
| 2083P0901X | Public Health & General Preventive Medicine Physician | L9018 | TX | Yes |

## Other

- **Enumeration date:** 08/01/2018
- **Last updated:** 11/20/2018