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PREMIER ORTHOPEDICS OF FORT WORTH NPI 1851652457


NPI Information

NPI: 1851652457
Provider Name: PREMIER ORTHOPEDICS OF FORT WORTH

Former Legal Business Name: KRAIG R PEPPER DO PA

Classification: Orthopaedic Surgery - 207XX0005X
Entity Type: Organization

Specialization: Sports Medicine

CLIA Number: 45D2095625

Address:
6930 HARRIS PARKWAY
SUITE 130
FORT WORTH, TX
ZIP 76132
Phone: (817) 632-0020
Get Directions

PREMIER ORTHOPEDICS OF FORT WORTH is a sports medicine orthopaedic surgery in Fort Worth, TX. The provider is an orthopaedic surgeon trained in sports medicine provides appropriate care for all structures of the musculoskeletal system directly affected by participation in sporting activity. This specialist is proficient in areas including conditioning, training and fitness, athletic performance and the impact of dietary supplements, pharmaceuticals, and nutrition on performance and health, coordination of care within the team setting utilizing other health care professionals, field evaluation and management, soft tissue biomechanics and injury healing and repair. Knowledge and understanding of the principles and techniques of rehabilitation, athletic equipment and orthotic devices enables the specialist to prevent and manage athletic injuries. PREMIER ORTHOPEDICS OF FORT WORTH NPI is 1851652457. The provider is registered as an organization entity type and is a single specialty group.
The provider Former Legal Business Name Is Kraig R Pepper Do Pa.

The provider's business location address is:

6930 HARRIS PARKWAY
SUITE 130
FORT WORTH, TX
ZIP 76132
Phone: (817) 632-0020
Fax: (817) 632-0022

The provider's authorized official is Kraig R. Pepper .
The authorized official title is Owner and has the following contact phone number (817) 632-0020.

The CLIA number assigned to this NPI record is 45D2095625 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/31/2012 and was last updated on 2/16/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207XX0005XOrthopaedic SurgerySports MedicineYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1203808502MEDICAIDTEXAS
2308841101MEDICAIDTEXAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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