365 SPINE CARE OF NORTH TEXAS, PLLC (NPI# 1730696956) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730696956 |
| Entity Type | Organization |
| Organization Name | 365 SPINE CARE OF NORTH TEXAS, PLLC |
| Practice Address |
8080 Independence Pkwy Ste 230 Plano TX 75025-4013 |
| Practice Telephone | 4696930165 |
| Mailing Telephone | 4696930165 |
| Enumeration Date | 2018-01-09 |
| Last Update Date | 2019-06-11 |
| Authorized Official Name | KENDALL EDWARD CARLL II (OWNER/MANAGER) |
| Authorized Official Telephone | 4696930165 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207X00000X | Orthopaedic Surgery | TRN6843 | FL | Allopathic & Osteopathic Physicians |
| Y | 207XS0117X |
Orthopaedic Surgery Specialization: Orthopaedic Surgery of the Spine |
M8573 | TX | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 240 Adriatic Pkwy, Mckinney, TX 750708278 | 4699982273 | 4699982272 |
| 4461 Coit Rd Ste 101, Frisco, TX 750350522 | 4699982273 | |
| 8080 Independence Pkwy Ste 110, Plano, TX 750254004 | 4699982273 | 4699982272 |
| Street Address |
8080 INDEPENDENCE PKWY STE 230 |
| City | PLANO |
| State | TX |
| Zip Code | 75025-4013 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063596997 | Kendall Edward Carll II | Orthopaedic Surgery | 8080 Independence Pkwy Ste 230, Plano, TX 75025 | 2006-10-25 |
| 1831698703 | Krap, Pllc | Orthopaedic Surgery | 8080 Independence Pkwy Ste 230, Plano, TX 75025-4013 | 2018-02-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518425982 | Mary Deena Jacob | Nurse Practitioner | 2865 Mcdermott Rd #225, Plano, TX 75025 | 2019-03-05 |
| 1093295545 | Surgery Center 121 LLC | Clinic/Center | 9955 Gillespie Drive Suite 200, Plano, TX 75025 | 2018-08-15 |
| 1902383136 | Quang Dangtran | Adult Companion | 7604 Stoney Point Dr, Plano, TX 75025 | 2018-07-20 |
| 1598256851 | Rachel J Dove | Behavioral Analyst | 8900 Smokey Dr, Plano, TX 75025 | 2018-05-22 |
| 1659879641 | Beatrice Wambui Ngaruiya | Pharmacist | 312 Preston Rd, Plano, TX 75025 | 2018-01-25 |
| 1841718392 | Ngonje Emilia Dibaki | Community Health Worker | 7900 Stable Glen Drive, Plano, TX 75025 | 2017-09-05 |
| 1497280408 | Js Pedodontics Pllc | Dentist | 3555 National Drive, Ste. 200, Plano, TX 75025 | 2017-04-27 |
| 1093254013 | Mark T. Padilla, Pllc | Dentist | 3555 National Dr, Ste 300, Plano, TX 75025 | 2017-02-23 |
| 1982147708 | Dentspan Pllc | Dentist | 3680 Sh 121, 100, Plano, TX 75025 | 2016-11-28 |
| 1669827093 | Raz Silberman | Community Health Worker | 9708 Congressional Dr, Plano, TX 75025 | 2016-05-04 |
| Find all providers in zip 75025 | ||||
| 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 |
|---|---|---|---|---|
| 1386037273 | Prism Orthopedic | Orthopaedic Surgery | 7712 San Jacinto Pl Ste 200, Plano, TX 75024-3212 | 2015-03-17 |
| 1194930453 | Mark Charlie Valente | Orthopaedic Surgery | 7712 San Jacinto Pl, Suite 200, Plano, TX 75024-3257 | 2007-05-11 |
| 1114926276 | Donald Mackenzie | Orthopaedic Surgery | 5038 Tennyson Pkwy Ste B, Plano, TX 75024-2954 | 2005-07-20 |
| 1023013141 | Stephen P Courtney | Orthopaedic Surgery | 1705 Ohio Dr Ste 300, Plano, TX 75093 | 2005-06-15 |
| 1831698703 | Krap, Pllc | Orthopaedic Surgery | 8080 Independence Pkwy Ste 230, Plano, TX 75025-4013 | 2018-02-06 |
| 1639556350 | Robert Chase Stockton | Orthopaedic Surgery | 6020 W Parker Rd Ste 200, Plano, TX 75093-8172 | 2015-05-01 |
| 1043697279 | Daniel Nuri Kiridly | Orthopaedic Surgery | 6020 W Parker Rd Ste 200, Plano, TX 75093-8172 | 2015-04-27 |
| 1265828420 | David Barnes | Orthopaedic Surgery | 6020 W Parker Rd Ste 200, Plano, TX 75093-8172 | 2015-04-14 |
| 1548656820 | Joseph Albano | Orthopaedic Surgery | 6020 W Parker Rd Ste 200, Plano, TX 75093-8172 | 2015-04-13 |
| 1194113225 | Texas Spine Consultants, LLP | Orthopaedic Surgery | 8080 Independence Pkwy Ste 200, Plano, TX 75025-4002 | 2014-12-23 |
| Find all providers in PLANO | ||||
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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.