Organization
DESOTO SPINE CENTER, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RAYMOND E. NEWSOME D.C. (OWNER)
(469) 567-8242
Entity
Organization
Contact information
Practice address
1233 E PLEASANT RUN RD, SUITE B, DESOTO, TX 75115-4200
(469) 567-8242
(469) 567-8290
Mailing address
1233 E PLEASANT RUN RD, SUITE B, DESOTO, TX 75115-4200
(469) 567-8242
(469) 567-8290
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
5472
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
84NV
BLUE CROSS/BLUE SHIELD
TX
Enumeration date
10/20/2009
Last updated
10/20/2009
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