| North Texas Sport And Spine | |
|
8380 Warren Pkwy Ste 110 Frisco TX 75034-4311 | |
| (214) 773-0345 | |
| Not Available |
| Full Name | North Texas Sport And Spine |
|---|---|
| Speciality | Clinic/Center |
| Location | 8380 Warren Pkwy Ste 110, Frisco, Texas |
| Authorized Official Name and Position | Samuel Gaston (OWNER) |
| Authorized Official Contact | 2145779846 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| North Texas Sport And Spine 6030 Milton St Apt 3114 Dallas TX 75206-4439 Ph: (214) 577-9846 | North Texas Sport And Spine 8380 Warren Pkwy Ste 110 Frisco TX 75034-4311 Ph: (214) 773-0345 |
| NPI Number | 1528882750 |
|---|---|
| Provider Enumeration Date | 11/13/2024 |
| Last Update Date | 11/13/2024 |
| Medicare PECOS PAC ID | 0547797433 |
|---|---|
| Medicare Enrollment ID | O20241217000127 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528882750 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Samuel R Gaston |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1780116582 PECOS PAC ID: 5597012823 Enrollment ID: I20181107003292 |
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