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Organization

CENTEX SPINE, LLC

Active
Other names
Austin Preferred Spine and Sports Rehab
Organization subpart
No

Provider details

NPI number
Authorized official
JEFFREY FLUITT D.C. (OWNER)
(512) 442-2727
Entity
Organization

Contact information

Practice address
4316 JAMES CASEY ST, BLDG B, SUITE 201, AUSTIN, TX 78745-1116
(512) 442-2727
(512) 442-2728
Mailing address
PO BOX 5927, AUSTIN, TX 78763-5927
(512) 442-2727
(512) 442-2728

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
8815
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0052WV
BCBS GROUP PROVIDER RECORD ID
TX
Enumeration date
08/02/2011
Last updated
08/29/2013
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