Provider Demographics
NPI:1053185603
Name:SPINE DISORDERS OF TEXAS PLLC
Entity type:Organization
Organization Name:SPINE DISORDERS OF TEXAS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DUANE
Authorized Official - Middle Name:
Authorized Official - Last Name:PITT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:602-218-6556
Mailing Address - Street 1:1029 LONG PRAIRIE RD STE D
Mailing Address - Street 2:
Mailing Address - City:FLOWER MOUND
Mailing Address - State:TX
Mailing Address - Zip Code:75022-4344
Mailing Address - Country:US
Mailing Address - Phone:602-218-6556
Mailing Address - Fax:
Practice Address - Street 1:1029 LONG PRAIRIE RD STE D
Practice Address - Street 2:
Practice Address - City:FLOWER MOUND
Practice Address - State:TX
Practice Address - Zip Code:75022-4344
Practice Address - Country:US
Practice Address - Phone:602-218-6556
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-14
Last Update Date:2023-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty