OrganizationSpine MinivasiveDurable Medical Equipment & Medical SuppliesSuppliersPractice Address2646 S Loop W, 360, Houston, TX 77054-2665(888) 959-7088PECOS EnrollmentBased on the most recent information from CMS, provider Spine Minivasive does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 11:47 AM.Profile DetailsProvider ID1336492487Provider TypeOrganizationFull NameSpine MinivasiveSubpartNoEnumeration Date10/25/2012Last Updated10/25/2012Contact InformationPractice LocationPractice Address2646 S Loop W, 360, Houston, TX 77054-2665Phone(888) 959-7088FaxUnlisted FaxMailing LocationMailing Address2646 S Loop W, 360, Houston, TX 77054-2665Phone(888) 959-7088FaxUnlisted FaxAuthorized OfficialNamePhan, Phillip C (Owner)Phone(888) 959-7088Provider TaxonomiesCodeDescriptionLicenseCode332B00000XPrimaryDescriptionDurable Medical Equipment & Medical SuppliesSuppliersLicenseUnlisted IssuerCode335E00000XDescriptionProsthetic/Orthotic SupplierSuppliersLicenseUnlisted Issuer