EVOLUTION PAIN CENTERS LLC NPI 1093205858

NPI Information

NPI: 1093205858
Provider Name: EVOLUTION PAIN CENTERS LLC

Doing Business As: FORT WORTH PAIN CENTER

Classification: Clinic/Center - 261QP3300X
Entity Type: Organization

Specialization: Pain

Address:
6789 CAMP BOWIE BLVD
FORT WORTH, TX
ZIP 76116
Phone: (817) 886-4654
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EVOLUTION PAIN CENTERS LLC is a pain clinic center in Fort Worth, TX. EVOLUTION PAIN CENTERS LLC NPI is 1093205858. The provider is registered as an organization entity type.
The provider Is Doing Business As Fort Worth Pain Center.

The provider's business location address is:

6789 CAMP BOWIE BLVD
FORT WORTH, TX
ZIP 76116-112
Phone: (817) 886-4654
Fax: (817) 489-5149

The provider's authorized official is Joseph Ysbrand .
The authorized official title is Partner and has the following contact phone number (817) 372-1719.

The enumeration date for this NPI number is 5/16/2018 and was last updated on 5/16/2018.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QP3300X	Clinic/Center	Pain			Yes

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: 11/14/2023

NPI Synchronization or Removal

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