Organization
CAPTIVE MEDICAL, PLLC
Active
Other names
Captive Medical, PA
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JASON CHRISTOPHER TINLEY M.D. (DIRECTOR)
(817) 916-4685
Entity
Organization
Contact information
Practice address
649 NE ALSBURY BLVD, STE 105, BURLESON, TX 76028-2660
(817) 426-1212
Mailing address
649 NE ALSBURY BLVD, STE 105, BURLESON, TX 76028-2660
Taxonomy
Speciality
Code
Description
License number
State
207XS0117X
Orthopaedic Surgery of the Spine Physician
Primary
—
—
363AS0400X
Surgical Physician Assistant
—
—
Other
Enumeration date
08/11/2012
Last updated
05/28/2015
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