# SPINE TEAM TEXAS, PA

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

## Provider details

- **NPI number:** 1053798983
- **Authorized official:** MARK HOOD (CEO)
- **Authorized official phone:** (817) 442-9300

## Contact information

- **Practice address:** 1105 CENTRAL EXPY N \# 2370, MOB II, ALLEN, TX 75013-6103
- **Practice address phone:** (972) 772-9600
- **Practice address fax:** (972) 772-9601
- **Mailing address:** 1545 E SOUTHLAKE BLVD, SUITE 100, SOUTHLAKE, TX 76092-6422
- **Mailing address phone:** (817) 442-9300
- **Mailing address fax:** (817) 796-0763

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | NULL | Yes |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | — | Yes |
| 208600000X | Surgery Physician | — | NULL | — |
| 208600000X | Surgery Physician | — | — | — |

## Other

- **Enumeration date:** 04/29/2015
- **Last updated:** 04/29/2015