Organization
AXIS BRAIN AND BACK INSTITUTE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SAEID ESMAEILY ARYAN DO (OWNER/PRESIDENT)
(817) 502-7411
Entity
Organization
Contact information
Practice address
1110 E STATE HIGHWAY 114 STE 100, SOUTHLAKE, TX 76092-5251
(817) 502-7411
(817) 502-7412
Mailing address
1110 E STATE HIGHWAY 114 STE 100, SOUTHLAKE, TX 76092-5251
(817) 502-7411
(817) 502-7412
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
P9148
TX
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
—
—
225100000X
Physical Therapist
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00E4E2
BCBS
TX
01
—
7273750001
MEDICARE NSC
—
Enumeration date
05/19/2014
Last updated
08/28/2025
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