# EQUINOX CLINIC PLLC

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

## Provider details

- **NPI number:** 1902259385
- **Authorized official:** ANDREW ALBERT INDRESANO (MD)
- **Authorized official phone:** (972) 707-0005

## Contact information

- **Practice address:** 3160 N TARRANT PKWY STE 404, FORT WORTH, TX 76177-8614
- **Practice address phone:** (972) 707-0005
- **Mailing address:** 1141 N LOOP 1604 E \# 105-612, SAN ANTONIO, TX 78232-1339

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207XS0117X | Orthopaedic Surgery of the Spine Physician | — | TX | — |
| 363A00000X | Physician Assistant | — | NULL | Yes |
| 363A00000X | Physician Assistant | — | — | Yes |
| 363AS0400X | Surgical Physician Assistant | — | NULL | — |
| 363AS0400X | Surgical Physician Assistant | — | — | — |

## Other

- **Enumeration date:** 07/20/2016
- **Last updated:** 12/06/2024