Organization
CY-FAIR BONE AND JOINT
Active
Other names
Advanced Orthopaedics and Sports Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID ROSS MACK MD (MANAGING PARTNER)
(281) 955-7577
Entity
Organization
Contact information
Practice address
455 SCHOOL ST, SUITE 24, TOMBALL, TX 77375-4595
(281) 955-7577
(281) 955-5875
Mailing address
11800 FM 1960 RD W, HOUSTON, TX 77065-3840
(281) 955-7577
(281) 955-5875
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00897R
MEDICARE PTAN
TX
Enumeration date
02/10/2009
Last updated
11/23/2011
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