Provider Demographics
NPI:1487449591
Name:UNITED SPINE AND PAIN CENTER PLLC
Entity type:Organization
Organization Name:UNITED SPINE AND PAIN CENTER PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:ALEXANDER
Authorized Official - Last Name:CHURCH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-858-1882
Mailing Address - Street 1:15511 W STATE HIGHWAY 71 STE 110
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78738-2825
Mailing Address - Country:US
Mailing Address - Phone:713-858-1882
Mailing Address - Fax:
Practice Address - Street 1:209 N BONNIE BRAE ST STE 200
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76201-3748
Practice Address - Country:US
Practice Address - Phone:815-505-9041
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-10
Last Update Date:2025-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Single Specialty