Organization
SPINE TEAM TEXAS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARK C HOOD (CEO)
(817) 442-9300
Entity
Organization
Contact information
Practice address
1545 E SOUTHLAKE BLVD, SUITE 100, SOUTHLAKE, TX 76092
(817) 442-9300
(917) 416-0108
Mailing address
1545 E SOUTHLAKE BLVD, SUITE 100, SOUTHLAKE, TX 76092
(817) 442-9300
(917) 416-0108
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
—
—
2081P0004X
Spinal Cord Injury Medicine Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00959Z
MEDICARE PTAN
TX
Enumeration date
07/29/2006
Last updated
07/17/2014
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