# PERFORMANCE SPINE AND SPORTS MEDICINE

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

## Provider details

- **NPI number:** 1669769055
- **Authorized official:** DR. VISHAL S KANCHERLA D.O. (PHYSICIAN)
- **Authorized official phone:** (512) 327-8800

## Contact information

- **Practice address:** 4613 BEE CAVE RD STE 105, WEST LAKE HILLS, TX 78746-5206
- **Practice address phone:** (512) 327-8800
- **Practice address fax:** (512) 327-8802
- **Mailing address:** 4613 BEE CAVE RD STE 105, WEST LAKE HILLS, TX 78746-5206
- **Mailing address phone:** (512) 327-8800
- **Mailing address fax:** (512) 327-8802

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2081P2900X | Pain Medicine (Physical Medicine & Rehabilitation) Physician | M6218 | TX | Yes |

## Other

- **Enumeration date:** 07/06/2011
- **Last updated:** 07/06/2011