Organization
SPORTS & SPINE ASSOCIATES, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LORI BETH WASSERBURGER M.D. (PRESIDENT)
(512) 358-0500
Entity
Organization
Contact information
Practice address
7756 NORTHCROSS DR, SUITE 203, AUSTIN, TX 78757-1735
(512) 358-0500
(512) 358-0520
Mailing address
PO BOX 27165, AUSTIN, TX 78755-2165
(512) 358-0500
(512) 358-0520
Taxonomy
Speciality
Code
Description
License number
State
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
H2890
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1033217450
NPI
TX
01
—
4295756
AETNA
TX
01
—
80W550
BCBS
TX
01
—
E98496
UPIN
TX
Enumeration date
07/13/2007
Last updated
05/22/2013
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