TBSI Neurosurgery


Frequently Asked Questions

A partial list of diseases treated:

  • Aneurysms
  • Vascular Malformations
  • Intracranial Hemorrhage
  • Brain Tumors
  • Acoustic Neuromas
  • Trigeminal Neuralgia
  • Cervical and Lumbar
  • Stenosis


For a more comprehensive list, please click here.

If your insurance requires a referral or authorization to see a specialist, you will be required to have a referral from your Primary Care Provider. We must have this written referral prior to scheduling an appointment.

TBSI Neurosurgery participates with a large number of insurance plans; however, you will need to verify our participation with your plan before your appointment. If you are on a managed care plan, please confirm that we have received prior authorization for your visit. Unfortunately, we do not accept Blue Cross Blue Shield HMO, CHIP and Star Plus.

Please note: When calling your insurance company to verify our participation with your plan, they may ask for our tax id number. Our tax id number is ​741282696.

Our office will contact you within 3-5 days to schedule your appointment, once we receive the referral. You may also contact our office to schedule an appointment at 979-776-8896.

 As a new patient, you will be asked to bring the following to your first appointment:

  • Completed New Patient Forms
  • Insurance card
  • Driver’s license
  • All related MRI’s, CT’s/studies
  • Any previous medical records, especially tests results

The PA usually initiates the initial office visit to gather medical history from the patients. The PA will evaluate you and order any studies if they are needed and will then have you come back to see the doctor. This will also allow all patients to be seen in a timely manner.

To obtain a copy of your medical records, we must have a signed Release of Records on file. You can locate this form in the Forms Section. Please note, our office has 14 business days to process the request. All patients first request for medical records is provided at no charge. Any additional requests, there will be a $25.00 processing fee.

Please contact your pharmacy and request a refill through them. The pharmacy will send our office a refill request. Please allow at least 24 hours to process the request. If a refill request is received on a Friday afternoon, it could possibly be Monday until a response is received.

You may submit your FMLA and/or short-term disability forms to our office for the providers to complete. Once they are completed, they will be faxed/mailed back to the designated person. Please be aware, it takes a significant amount of time to complete the detailed forms so we are unable to do so during your office appointment.

Please allow up to 5 days for our scheduling staff to contact you with the information for your scheduled tests and/or surgery.

 If you have insurance, our office will not require any fees up front. However, you may be responsible to pay your deductible, etc. at the hospital. The hospital will contact you once your surgery is scheduled with that information.

If you are a self- pay patient, you will need to speak with our Surgery Schedulers to discuss payment for your surgery. It is our policy that we collect 50% of the surgery fees prior to your surgery, in addition to what the hospital may require up front.

You may be able to return to work within 2-4 weeks, depending on your procedure. Also depending on your procedure and your job, will determine if you will be fully released to go back to work or released to go back to work with restrictions. At your first follow up visit, you and your provider can discuss and plan your return to work.

In a true emergency, please call 911 or go immediately to the Emergency Department of the nearest hospital, where the physician on duty will begin treatment and contact our physician on call if necessary.

If you have a problem and it is non-life threatening, you may call our office at 979-776-8896. Your call will be forwarded to our answering service to take your message and forward it to the on-call doctor.

The primary goal of TBSI Neurosurgery is providing excellence in patient care. Many people are misinformed and believe that spine surgery is the ONLY way to achieve the ability to resume normal function and activities without pain. Although, in some cases, spine surgery is the best and most appropriate method of treatment, there are many nonsurgical care options available.

Options such as time, medication, relaxation techniques, deep breathing, body awareness, imagery, epidural steroid injections (ESI), and physical therapy all can help contribute to a better outcome for many conditions.

What is a PA?


Physician Assistants are health care professionals licensed to practice medicine with physician supervision. PAs employed by the federal government are credentialed to practice. As part of their comprehensive responsibilities, PAs conduct physical exams, diagnose and treat illnesses, order and interpret tests, counsel on preventive health care, assist in surgery, and in virtually all states can write prescriptions. Within the physician-PA relationship, physician assistants exercise autonomy in medical decision making and provide a broad range of diagnostic and therapeutic services. A PA’s practice may also include education, research, and administrative services.

PAs are trained in intensive education programs accredited by the Accreditation Review Commission on Education for the Physician Assistant (ARC-PA).

Because of the close working relationship the PAs have with physicians, PAs are educated in the medical model designed to complement physician training. Upon graduation, physician assistants take a national certification examination developed by the National Commission on Certification of PAs in conjunction with the National Board of Medical Examiners. To maintain their national certification, PAs must log 100 hours of continuing medical education every two years and sit for a recertification every six years. Graduation from an accredited physician assistant program and passage of the national certifying exam are required for state licensure.

In the mid-1960s, physicians and educators recognized there was a shortage and uneven distribution of primary care physicians. To expand the delivery of quality medical care, Dr. Eugene Stead of the Duke University Medical Center in North Carolina put together the first class of PAs in 1965. He selected Navy corpsmen who received considerable medical training during their military service and during the war in Vietnam but who had no comparable civilian employment. He based the curriculum of the PA program in part on his knowledge of the fast-track training of doctors during World War II.

Physician Assistant-certified. It means that the person who holds the title has met the defined course of study and has undergone testing by the National Commission on Certification of Physician Assistants (NCCPA). The NCCPA is an independent organization, and the commissioners represent a number of different medical professions. It is not a part of the PA professional organization, the American Academy of Physician Assistants (AAPA). To maintain that “C” after “PA”, a physician assistant must log 100 hours of continuing medical education every two years and take the recertification exam every six years.


Physician Assistants (PAs) are found in all areas of medicine. They practice in the areas of primary care medicine – that is family medicine, internal medicine, pediatrics, and obstetrics and gynecology — as well in surgery and the surgical subspecialties.

Physician Assistants receive a broad education in medicine. Their education is ongoing after graduation through continuing medical education requirements and continual interaction with physicians and other health care providers.

All 50 states, the District of Columbia, and Guam and the Commonwealth of the Northern Mariana Islands have enacted laws that authorize PA prescribing.

What a physician assistant does varies with training, experience, and state law. In addition, the scope of the PA’s practice corresponds to the supervising physician’s practice. In general, a physician assistant will see many of the same types of patients as the physician. The cases handled by physicians are generally the more complicated medical cases or those cases which require care that is not a routine part of the PA’s scope of work. Referral to the physician, or close consultation between the patient-PA-physician, is done for unusual or hard to manage cases. Physician assistants are taught to “know our limits” and refer to physicians appropriately. It is an important part of PA training.


Most physicians who have worked with physician assistants like having PAs on staff. The American Medical Association, the American College of Surgeons, the American Academy of Family Physicians, the American College of Physicians, and other national medical organizations support the physician assistant profession by actively supporting the PA certifying commission and the PA program accrediting agency.

Studies done by the Federal Government have shown that PAs, working with the supervision of physicians, provide care that is comparable to physician care. The Eighth Report to the President and Congress on the Status of Health Personnel in the United States (released in 1992) states, “Physician assistants have demonstrated their clinical effectiveness both in terms of quality of care and patient acceptance.”

The relationship between a PA and the supervising physician is one of mutual trust and respect. The physician assistant is a representative of the physician, treating the patient in the style and manner developed and directed by the supervising physician. The physician and PA practice as members of a medical team. In 1995, the American Medical Association developed suggested guidelines for how physicians and PAs should work as a team in the delivery of medical care.

Suggested Guidelines for Physician-Physician Assistant Practice Adopted by the AMA House of Delegates, June 1995.

Reflecting the comments from the American Academy of Physician Assistants, separate model guidelines for Physician/Physician Assistants practice have been developed. These are based on the unique relationship of Physician Assistants who recognize themselves as agents of physicians with respect to delegated medical acts, and legal responsibilities. They are consistent with the existing AMA policies concerning Physician Assistants cited in this report. In all settings, Physician Assistants recognize physician supervision in the delivery of patient care. The suggested guidelines reflect those as follows:

  • Health care services delivered by physicians and Physician Assistants must be within the scope of each practitioners authorized practice as defined by state law.
  • The physician is ultimately responsible for coordinating and managing the care of patients and, with the appropriate input of the Physician Assistant, ensuring the quality of health care provided to patients.
  • The physician is responsible for the supervision of the Physician Assistant in all settings.
  • The role of the Physician Assistant(s) in the delivery of care should be defined through mutually agreed upon guidelines that are developed by the physician and the Physician Assistant and based on the physician’s delegatory style.
  • The physician must be available for consultation with the Physician Assistant at all times either in person or through telecommunication systems or other means.
  • The extent of the involvement by the Physician Assistant in the assessment and implementation of treatment will depend on the complexity and acuity of the patient’s condition and the training and experience and preparation of the Physician Assistant as adjudged by the physician.
  • Patients should be made clearly aware at all times whether they are being cared for by a physician or a Physician Assistant.
  • The physician and Physician Assistant together should review all delegated patient services on a regular basis, as well as the mutually agreed upon guidelines for practice.
  • The physician is responsible for clarifying and familiarizing the Physician Assistant with his supervising methods and style of delegating patient care.

Physician assistants are educated in the “medical model”; in some schools they attend many of the same classes as medical students.

One of the main differences between PA education and physician education is not the core content of the curriculum, but the amount of time spent in formal education. In addition to time in school, physicians are required to do an internship, and the majority also complete a residency in a specialty following that. PAs do not have to undertake an internship or residency.

A physician has complete responsibility for the care of the patient. PAs share that responsibility with the supervising physicians.


The AAPA is the only national professional society to represent all physician assistants in every area of medicine. Founded in 1968, the academy has a federated structure of 57 chartered chapters representing PAs in all 50 states, the District of Columbia, Guam, and the federal services.

AAPA’s mission is to provide quality, cost-effective, and accessible health care as well as to support the professional and personal development of PAs. The AAPA pursues these goals through government relations and public education programs, research and data collection efforts, and continuing education activities.

The Academy’s policies are set by the House of Delegates, which meets once a year, and implemented by the Board of Directors. The House of Delegates is made up of representatives from the chartered chapters, specialty organizations, the Student Academy, and the Physician Assistant Education Association. Member projects and activities are assisted by the AAPA staff. A calendar of upcoming AAPA events is available on this Web site.

PAEA is a national organization whose members are the PA programs and individual PA educators. It includes representation from accredited programs and programs going through the accreditation process.

For more information about PAs and the PA profession please visit the AAPA website at www.aapa.org

As the philanthropic arm of the American Academy of Physician Assistants, the Physician Assistant Foundation’s mission is to foster education and research that enhance the delivery of quality health care. Related to this mission are the Foundation’s goals to increase the understanding of the physician assistant profession and to develop and promote philanthropic activities. Learn more about the PA Foundation at http://www.aapa.org/pa-foundation.

Get a Medical Consultation, Call 800-793-9106