Organization
EQUINOX CLINIC PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREW ALBERT INDRESANO (MD)
(972) 707-0005
Entity
Organization
Contact information
Practice address
3160 N TARRANT PKWY STE 404, FORT WORTH, TX 76177-8614
(972) 707-0005
Mailing address
1141 N LOOP 1604 E # 105-612, SAN ANTONIO, TX 78232-1339
Taxonomy
Speciality
Code
Description
License number
State
207XS0117X
Orthopaedic Surgery of the Spine Physician
—
TX
363A00000X
Physician Assistant
Primary
—
—
363AS0400X
Surgical Physician Assistant
—
—
Other
Enumeration date
07/20/2016
Last updated
12/06/2024
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