Provider Demographics
NPI:1275194417
Name:6060 SPINE/JOINT, PLLC
Entity type:Organization
Organization Name:6060 SPINE/JOINT, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING
Authorized Official - Prefix:
Authorized Official - First Name:ELSY
Authorized Official - Middle Name:
Authorized Official - Last Name:CELIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-673-9354
Mailing Address - Street 1:13101 PRESTON RD # 110648
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75240-5237
Mailing Address - Country:US
Mailing Address - Phone:214-980-9400
Mailing Address - Fax:469-802-0070
Practice Address - Street 1:7901 JOHN CARPENTER FWY
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75247-4832
Practice Address - Country:US
Practice Address - Phone:214-980-9400
Practice Address - Fax:469-802-0070
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-27
Last Update Date:2024-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
No208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty