NPI: 1770944076
Provider Name: CTPC FORT WORTH, PLLC
Former Legal Business Name: CENTRAL TEXAS PAIN CENTER - FORT WORTH, P.A.
Classification: Pain Medicine - 208VP0014X
Entity Type: Organization
Specialization: Interventional Pain Medicine
CLIA Number: 45D2113697
Address:
72356 BOAT CLUB ROAD
FORT WORTH, TX
ZIP 76179
Phone: (817) 667-9535
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CTPC FORT WORTH, PLLC is an interventional pain medicine pain medicine in Fort Worth, TX. The provider is interventional Pain Medicine is the discipline of medicine devoted to the diagnosis and treatment of pain and related disorders principally with the application of interventional techniques in managing subacute, chronic, persistent, and intractable pain, independently or in conjunction with other modalities of treatment. CTPC FORT WORTH, PLLC NPI is 1770944076. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Former Legal Business Name Is Central Texas Pain Center - Fort Worth, P.a..
The provider's business location address is:
72356 BOAT CLUB ROAD
FORT WORTH, TX
ZIP 76179-555
Phone: (817) 667-9535
Fax: (817) 667-9536
The provider's authorized official is Eric James Miller .
The authorized official title is Owner and has the following contact phone number (817) 667-9535.
The CLIA number assigned to this NPI record is 45D2113697 - physician office with a certificate type of Certificate of Waiver.
The enumeration date for this NPI number is 3/14/2016 and was last updated on 3/21/2018.