# INTERVENTIONAL SPINE ASSOCIATES, PA

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

## Provider details

- **NPI number:** 1457740672
- **Authorized official:** ROBERT M SUTHERLAND M.D. (OFFICER)
- **Authorized official phone:** (903) 593-1738

## Contact information

- **Practice address:** 5550 LBJ FWY, SUITE 360, DALLAS, TX 75240-6217
- **Practice address phone:** (903) 593-1738
- **Practice address fax:** (903) 596-7852
- **Mailing address:** PO BOX 7939, TYLER, TX 75711-7939
- **Mailing address phone:** (903) 593-1738
- **Mailing address fax:** (903) 596-7852

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | — | NULL | Yes |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | — | — | Yes |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | — |

## Other

- **Enumeration date:** 01/12/2015
- **Last updated:** 01/12/2015