NPI 1023578929

Baseline Diagnostic

Organisation Electrodiagnostic Medicine Physician Ft Worth, TX

Practice location

Address: 111 Boland St STE 211, Ft Worth, TX 76107-1265
Phone: (817) 529-8488
Fax: (903) 328-6568
Mailing address: PO Box 25403, Los Angeles, CA 90025-0403

Authorised official

Name: Gina Sullivan
Title: Billing Manager
Phone: (817) 529-8488

Registered specialties

Electrodiagnostic Medicine Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 204R00000X

Other Electrodiagnostic Medicine providers in Texas →

Registry record

NPI: 1023578929
Entity type: Organization
NPI issued: 25 Mar 2019
Record last updated: 25 Mar 2019

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.