# TEXOMA BRAIN AND SPINE SURGERY, PLLC

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

## Provider details

- **NPI number:** 1831136217
- **Authorized official:** DR. MICHAEL C MOLLESTON MD (NEUROSURGERON)
- **Authorized official phone:** (601) 606-0979

## Contact information

- **Practice address:** 5012 S US HIGHWAY 75 STE 220, DENISON, TX 75020-4598
- **Practice address phone:** (903) 416-6460
- **Practice address fax:** (866) 291-0393
- **Mailing address:** 5012 S US HIGHWAY 75 STE 220, DENISON, TX 75020-4598
- **Mailing address phone:** (903) 416-6460
- **Mailing address fax:** (866) 291-0393

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 173000000X | Legal Medicine | 14374 | MS | Yes |
| 173000000X | Legal Medicine | 14374MS | MS | — |

## Other

- **Enumeration date:** 06/02/2006
- **Last updated:** 08/15/2016