OrganizationActive
San Antonio Spine Surgery Center PLLC
NPI 1205082104 · Orthopaedic Surgery of the Spine Physician · Live Oak, TX
Provider details
- NPI number
- 1205082104
- Entity type
- Organization
- Primary specialty
- Orthopaedic Surgery of the Spine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Yvonne Lopez, Credentialing Coordinator(210) 615-8292
- License
- M9701 (TX)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Detailed profile(87/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
17 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
12501 Judson Rd
Ste 201
Live Oak, TX 78233-4103
Phone: (210) 615-8292
Fax: (210) 615-8297
Street-level locationGet directions
Mailing address
8255 Fredericksburg Rd
San Antonio, TX 78229-3357
Registry dates
- Enumerated
- 2008-08-11
- Last updated
- 2008-10-13
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.