Provider Demographics
NPI:1861422693
Name:ADVANCED SPINE & SCOLIOSIS INSTITUTE, P.A.
Entity type:Organization
Organization Name:ADVANCED SPINE & SCOLIOSIS INSTITUTE, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:B
Authorized Official - Last Name:RIMLAWI
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:214-948-6300
Mailing Address - Street 1:221 W COLORADO BLVD
Mailing Address - Street 2:SUITE 925, PAVILION II
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75208-2363
Mailing Address - Country:US
Mailing Address - Phone:214-948-6300
Mailing Address - Fax:214-948-6308
Practice Address - Street 1:221 W COLORADO BLVD
Practice Address - Street 2:SUITE 925, PAVILION II
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75208-2363
Practice Address - Country:US
Practice Address - Phone:214-948-6300
Practice Address - Fax:214-948-6308
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ADVANCED SPINE & SCOLIOSIS INSTITUE, PA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-07-04
Last Update Date:2008-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the SpineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX168291602Medicaid
TX00W963Medicare PIN
TX168291602Medicaid
TXH91811Medicare UPIN