Basic Information
| Provider Information | |||||||||
| NPI: | 1841651668 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ASPEN SPINE AND WELLNESS PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1780 W MCDERMOTT DR | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | ALLEN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 750133361 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9176856050 | ||||||||
| FaxNumber: | 4696563808 | ||||||||
| Practice Location | |||||||||
| Address1: | 10150 LEGACY DR | ||||||||
| Address2: | SUTIE 200 | ||||||||
| City: | FRISCO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 750336729 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9723859898 | ||||||||
| FaxNumber: | 8887706360 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/08/2016 | ||||||||
| LastUpdateDate: | 03/08/2016 | ||||||||
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| AuthorizedOfficialLastName: | SHAIKH | ||||||||
| AuthorizedOfficialFirstName: | ADNAN | ||||||||
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| AuthorizedOfficialTitleorPosition: | ADMIN | ||||||||
| AuthorizedOfficialTelephone: | 2144156845 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 111N00000X | TX | Y | 193200000X MULTI-SPECIALTY GROUP | Chiropractic Providers | Chiropractor |
No ID Information.