Provider Demographics
NPI:1780274571
Name:SPINOPTIM PLLC
Entity type:Organization
Organization Name:SPINOPTIM PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SHEYDWASSER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-913-3764
Mailing Address - Street 1:11811 FM 1960 RD W STE 165
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77065-3828
Mailing Address - Country:US
Mailing Address - Phone:713-913-3764
Mailing Address - Fax:713-913-3790
Practice Address - Street 1:11811 FM 1960 RD W STE 165
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77065-3828
Practice Address - Country:US
Practice Address - Phone:713-913-3764
Practice Address - Fax:713-913-3790
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-25
Last Update Date:2021-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Multi-Specialty
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Multi-Specialty