Organization
SPINE WORKS THERAPY-SOUTHLAKE, P.L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFERY B PHELPS M.D. (PRESIDENT)
(817) 616-0700
Entity
Organization
Contact information
Practice address
1001 W SOUTHLAKE BLVD, SOUTHLAKE, TX 76092-6010
(817) 310-0421
(817) 310-5870
Mailing address
1001 WEST SOUTHLAKE BLVD., SOUTHLAKE, TX 76092
(817) 310-0421
(817) 310-5870
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
L5053
TX
Other
Enumeration date
06/07/2011
Last updated
06/07/2011
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