SAN ANTONIO SPINE SURGERY CENTER PLLC (NPI# 1205082104) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205082104 |
| Entity Type | Organization |
| Organization Name | SAN ANTONIO SPINE SURGERY CENTER PLLC |
| Practice Address |
12501 Judson Rd Ste 201 Live Oak TX 78233-4103 |
| Mailing Address |
8255 Fredericksburg Rd San Antonio TX 78229-3357 |
| Practice Telephone | 2106158292 |
| Practice Fax Number | 2106158297 |
| Mailing Telephone | 2106158292 |
| Mailing Fax Number | 2106158297 |
| Enumeration Date | 2008-08-11 |
| Last Update Date | 2008-10-13 |
| Authorized Official Name | YVONNE LOPEZ (CREDENTIALING COORDINATOR) |
| Authorized Official Telephone | 2106158292 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207XS0117X |
Orthopaedic Surgery Specialization: Orthopaedic Surgery of the Spine |
M9701 | TX | Allopathic & Osteopathic Physicians |
| Street Address |
12501 JUDSON RD STE 201 |
| City | LIVE OAK |
| State | TX |
| Zip Code | 78233-4103 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912997347 | Phillip Dwight Cosby | Physician Assistant | 12501 Judson Rd, Suite 102, Live Oak, TX 78233-4103 | 2005-10-26 |
| 1093004467 | Scott Gorden Stafford, Dds, PC | Dentist | 12501 Judson Rd, Suite 101, Live Oak, TX 78233-4103 | 2011-04-06 |
| 1467752212 | Jeanne Yvette Contreras | Nurse Practitioner | 12501 Judson Rd, Ste.102, Live Oak, TX 78233-4103 | 2010-10-27 |
| 1760671440 | Huyen Nguyen Md Pa | Internal Medicine | 12501 Judson Rd, Suite 202, Live Oak, TX 78233-4103 | 2007-10-18 |
| 1023203585 | Tin Aung Hla,m.d.,p.a | Internal Medicine | 12501 Judson Rd, 202, Live Oak, TX 78233-4103 | 2007-09-07 |
| 1235298365 | Dabas Cancer Institute, P.a. | Specialist | 12501 Judson Rd, Suite 102, Live Oak, TX 78233-4103 | 2006-12-06 |
| 1629167929 | Huyen Thi Nguyen | Internal Medicine | 12501 Judson Rd, Suite 202, Live Oak, TX 78233-4103 | 2006-10-12 |
| 1831126937 | Richard Allen Nevill Jr. | Physician Assistant | 12501 Judson Rd, Suite 102, Live Oak, TX 78233-4103 | 2006-06-26 |
| 1447208384 | Basel Dabas | Internal Medicine | 12501 Judson Rd, Suite 102, Live Oak, TX 78233-4103 | 2006-05-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477162451 | Jennifer Chaghoury | Chore Provider | 4606 La Marquesa St, San Antonio, TX 78233 | 2020-07-27 |
| 1912515719 | Creative Health Care Management, LLC | Physical Therapist | 4415 Rio D'oro St, San Antonio, TX 78233 | 2020-07-17 |
| 1841822749 | Edilma Yosmara Medrano | Nurse's Aide | 209 Goforth Drive, San Antonio, TX 78233 | 2020-02-07 |
| 1578194411 | Jorge Javier Jaramillo De La Torre | Neurological Surgery | Cuauhtemoc 380, Col. Moderna, San Luis Potosi, SLP 78233 | 2020-01-29 |
| 1174182000 | Shenila Rajani Od Pllc | Optometrist | 12349 I-35, San Antonio, TX 78233 | 2019-06-13 |
| 1659935609 | Mff Amber Oaks LLC | Assisted Living Facility | 4415 Rio Doro St., San Antonio, TX 78233 | 2019-04-25 |
| 1457862302 | Antoinette Marie Powell | Massage Therapist | 14615 Interstate 35 N, Live Oak, TX 78233 | 2017-10-18 |
| 1154852150 | Dustin William Koenning | Pharmacist | 6019 Randolph Blvd., San Antonio, TX 78233 | 2017-03-22 |
| 1316481153 | U S Anesthesia Partners of Texas, Pa | Physician Assistant | 12602 Toepperwein Rd Ste 218, Live Oak, TX 78233 | 2016-12-13 |
| 1477096121 | Vanessa's Garden of Hope Assisted Living,llc | Assisted Living Facility | 4350 Shallow Water, San Antonio, TX 78233 | 2016-11-29 |
| Find all providers in zip 78233 | ||||
| Taxonomy Code | 207XS0117X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| Specialization | Orthopaedic Surgery of the Spine |
| Recognized by several state medical boards as a fellowship subspecialty program of orthopaedic surgery, orthopaedic surgeons of the spine deal with the evaluation and nonoperative and operative treatment of the full spectrum of primary spinal disorders including trauma, degenerative, deformity, tumor, and reconstructive. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. Separate board certification is not currently offered. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336761584 | Jfc Medical, Pllc | Orthopaedic Surgery | 6470 Naples Dr, Irving, TX 75039-4167 | 2020-05-11 |
| 1740812221 | Granthem Pllc | Orthopaedic Surgery | 8440 Walnut Hill Ln Ste 230, Dallas, TX 75231-3816 | 2020-02-12 |
| 1184270845 | Spine Dfw Pa | Orthopaedic Surgery | 440 W Lbj Fwy Ste 465, Irving, TX 75063-3869 | 2019-08-16 |
| 1083268338 | Mp Surgical Assists LLC | Orthopaedic Surgery | 4012 Duval St Unit B, Austin, TX 78751-5110 | 2019-07-25 |
| 1215405402 | Houston Scoliosis & Spine Institute, LLC | Orthopaedic Surgery | 3534 Vista Rd Ste 2000, Pasadena, TX 77504-1728 | 2018-11-06 |
| 1306332481 | Craig C Callewart Md Pa | Orthopaedic Surgery | 17051 Dallas Pkwy Ste 420, Addison, TX 75001-7115 | 2018-07-02 |
| 1013415397 | Total Joint Cin of West Texas LLC | Orthopaedic Surgery | 18911 Hardy Oak Blvd # B, San Antonio, TX 78258-4967 | 2018-01-31 |
| 1750889036 | Total Joint Cin of Austin LLC | Orthopaedic Surgery | 401 Congress Ave Ste 1540b, Austin, TX 78701-4071 | 2018-01-31 |
| 1578071452 | Spine Cin of West Texas LLC | Orthopaedic Surgery | 18911a Hardy Oak Blvd, San Antonio, TX 78258-4966 | 2018-01-13 |
| 1205344181 | Spine Cin of Austin LLC | Orthopaedic Surgery | 401 Congress Ave # 1540a, Austin, TX 78701-4071 | 2018-01-13 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.