Organization
SPINE TEAM TEXAS, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK HOOD (CEO)
(817) 442-9300
Entity
Organization
Contact information
Practice address
3142 HORIZON RD, SUITE 100, ROCKWALL, TX 75032-7809
(817) 442-9300
(817) 796-0763
Mailing address
1545 E SOUTHLAKE BLVD, SUITE 100, SOUTHLAKE, TX 76092-6422
(817) 442-9300
(817) 796-0763
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00957Z
MEDICARE PTAN
TX
Enumeration date
08/26/2009
Last updated
06/25/2014
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