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Contact Information

AXIS BRAIN AND BACK INSTITUTE PLLC
1110 E STATE HIGHWAY 114 STE 100
SOUTHLAKE, TX76092-5251
 Phone: 817-502-7411
 Fax: 817-502-7412
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Neurological Surgery

207T00000X 02 Physician/General Surgery
 

Durable Medical Equipment & Medical Supplies

332B00000X 54 Other Medical Supply Company
 

Pain Medicine

2081P2900X 25 Physician/Physical Medicine and Rehabilitation
 

Physical Therapist

225100000X 65 Physical Therapist in Private Practice
Indicates primary specialty

NPI Profile & details for AXIS BRAIN AND BACK INSTITUTE PLLC · (Female)

NPI # 1689085193
Status Active
Credentials
Entity Individual
Enumeration date 05/19/2014
Last updated 08/28/2025 - About 9 months ago
Sole proprietor 1 Not specified
Identifiers
  • TX License # P9148
  • Other 7273750001 MEDICARE NSC
  • TX Other 00E4E2 BCBS
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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