Organization
SPINE SURGERY SERVICE, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL HENNESSY MD (MBR)
(214) 370-3535
Entity
Organization
Contact information
Practice address
17051 DALLAS PKWY STE 400, ADDISON, TX 75001-7108
(210) 598-4262
Mailing address
1141 N LOOP 1604 E # 105-612, SAN ANTONIO, TX 78232-1339
(201) 598-4262
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Enumeration date
08/15/2018
Last updated
09/07/2023
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