Organization
EAST TEXAS SPINE INSTITUTE, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RITESH R PRASAD (OWNER)
(903) 593-9999
Entity
Organization
Contact information
Practice address
3110 PARK CENTER DR, TYLER, TX 75701-9215
(903) 593-9999
(903) 526-4239
Mailing address
PO BOX 130940, TYLER, TX 75713-0940
(903) 593-9999
(903) 526-4239
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
K1283
TX
Other
Enumeration date
11/14/2007
Last updated
06/11/2012
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