Provider Demographics
NPI:1699786574
Name:LORDEX SPINE INSTITUTE INC.
Entity type:Organization
Organization Name:LORDEX SPINE INSTITUTE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:DUNN
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:713-877-9355
Mailing Address - Street 1:PO BOX 128
Mailing Address - Street 2:
Mailing Address - City:BELLAIRE
Mailing Address - State:TX
Mailing Address - Zip Code:77402-0128
Mailing Address - Country:US
Mailing Address - Phone:281-833-3325
Mailing Address - Fax:281-833-3323
Practice Address - Street 1:3000 WESLAYAN ST
Practice Address - Street 2:STE 150
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77027-5700
Practice Address - Country:US
Practice Address - Phone:713-877-9355
Practice Address - Fax:821-833-3323
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-10
Last Update Date:2011-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9250111NN1001X
TX1017408225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No111NN1001XChiropractic ProvidersChiropractorNutritionGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00119ZMedicare PIN