Provider Demographics
NPI:1730334897
Name:TEXAS NONSURGICAL ORTHOPEDIC & SPINE CENTER, P.A.
Entity type:Organization
Organization Name:TEXAS NONSURGICAL ORTHOPEDIC & SPINE CENTER, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:PERL
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:817-446-8778
Mailing Address - Street 1:5601 BRIDGE ST
Mailing Address - Street 2:SUITE #510
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76112-2384
Mailing Address - Country:US
Mailing Address - Phone:817-446-8778
Mailing Address - Fax:817-446-8558
Practice Address - Street 1:5601 BRIDGE ST
Practice Address - Street 2:SUITE #510
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76112-2384
Practice Address - Country:US
Practice Address - Phone:817-446-8778
Practice Address - Fax:817-446-8558
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-17
Last Update Date:2008-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM02562081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX611498Medicare UPIN