PENN INTERVENTIONAL PAIN CENTER LLC NPI 1124310073

NPI Information

NPI: 1124310073
Provider Name: PENN INTERVENTIONAL PAIN CENTER, LLC
Classification: Clinic/Center - 261QP3300X
Entity Type: Organization

Specialization: Pain

Address:
1201 SUMMIT AVE
SUITE 400
FORT WORTH, TX
ZIP 76102
Phone: (972) 234-4740
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PENN INTERVENTIONAL PAIN CENTER, LLC is a pain clinic center in Fort Worth, TX. PENN INTERVENTIONAL PAIN CENTER, LLC NPI is 1124310073. The provider is registered as an organization entity type.

The provider's business location address is:

1201 SUMMIT AVE
SUITE 400
FORT WORTH, TX
ZIP 76102-413
Phone: (972) 234-4740
Fax: (817) 571-0897

The provider's authorized official is Ted Grosbeck .
The authorized official title is Manager and has the following contact phone number (469) 362-6909.

The enumeration date for this NPI number is 5/11/2011 and was last updated on 5/11/2011.

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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