| Integrated Spinal Solutions, Pllc | |
|
6001 Harris Pkwy Fort Worth TX 76132-4103 | |
| (817) 768-3899 | |
| (817) 370-6401 |
| Full Name | Integrated Spinal Solutions, Pllc |
|---|---|
| Speciality | General Practice |
| Location | 6001 Harris Pkwy, Fort Worth, Texas |
| Authorized Official Name and Position | Lee Brandon Hartman (AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 8173706350 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Integrated Spinal Solutions, Pllc 6001 Harris Pkwy Fort Worth TX 76132-4103 Ph: (817) 768-3899 | Integrated Spinal Solutions, Pllc 6001 Harris Pkwy Fort Worth TX 76132-4103 Ph: (817) 768-3899 |
| NPI Number | 1104247634 |
|---|---|
| Provider Enumeration Date | 12/31/2013 |
| Last Update Date | 06/21/2024 |
| Medicare PECOS PAC ID | 0941425730 |
|---|---|
| Medicare Enrollment ID | O20140711000608 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104247634 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Paul B Bourland |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790101624 PECOS PAC ID: 0446573489 Enrollment ID: I20141229000123 |
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