Organization
SPINE INFORMATICS AUSTIN, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GERALD LEE DEVRIES JR. INVESTOR (GENERAL MANAGER)
(512) 913-1834
Entity
Organization
Contact information
Practice address
110 WILD BASIN RD STE 250, WEST LAKE HILLS, TX 78746-3352
(512) 531-9912
(512) 537-1537
Mailing address
3202 SWEET AUTUMN CV, AUSTIN, TX 78735-1524
(512) 913-1834
(512) 537-1537
Taxonomy
Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
Primary
—
—
Other
Enumeration date
09/15/2017
Last updated
09/15/2017
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