CC1 MEDICAL HOLDING LLC
NPI 1093423535
Electrodiagnostic Medicine in Ft Worth, TX

Active since November 14, 2022
111 BOLAND ST STE 211, FT WORTH, TX 76107(817) 529-8488(903) 328-6568 Get Directions Write a Review

NPPES record last updated: November 14, 2022. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Cc1 Medical Holding Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CC1 MEDICAL HOLDING LLC (NPI 1093423535) is a healthcare organization registered as an electrodiagnostic medicine in Ft Worth, Texas and active in the NPI registry since November 2022. The organization lists Gina Sullivan, Practice Administrators, as its authorized official.

NPPES Registry Identity

NPI1093423535
Entity TypeOrganization
Primary Taxonomy204R00000X
Legal Business NameCC1 MEDICAL HOLDING LLC
Location Address111 BOLAND ST STE 211Ft Worth, TX 76107-1265
Mailing Address111 Boland St Ste 211Ft Worth, TX 76107-1265 · (817) 529-8488
Fax(903) 328-6568
Organization SubpartNo
Authorized OfficialGina SullivanPractice Administrators · (903) 259-0550
Enumeration DateNovember 14, 2022
NPPES CertifiedNovember 14, 2022
NPI 1093423535 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyElectrodiagnostic MedicineAllopathic & Osteopathic Physicians
Taxonomy Code204R00000X
Definition

Electrodiagnostic medicine is the medical subspecialty that applies neurophysiologic techniques to diagnose, evaluate, and treat patients with impairments of the neurologic, neuromuscular, and/or muscular systems. Qualified physicians are trained in performing electrophysiological testing and interpretation of the test data. They require knowledge in anatomy, physiology, kinesiology, histology, and pathology of the brain, spinal cord, autonomic nerves, cranial nerves, peripheral nerves, neuromuscular junction, and muscles. They must know clinical features and treatment of diseases of the central, peripheral, and autonomic nervous systems, as well as those of neuromuscular junction and muscle. Physicians also require special knowledge about electric signal processing, including waveform analysis, electronics and instrumentation, stimulation and recording equipment, and statistics.

111 BOLAND ST STE 211, Ft Worth, TX 76107

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Electrodiagnostic Medicine
111 BOLAND ST STE 211
FT WORTH, TX 76107
Specialist/Technologist, Other (Electroneurodiagnostic)
111 BOLAND ST STE 211
FT WORTH, TX 76107
Electrodiagnostic Medicine
111 BOLAND ST STE 211
FT WORTH, TX 76107
Electrodiagnostic Medicine
111 BOLAND ST STE 211
FT WORTH, TX 76107
Specialist/Technologist, Other
111 BOLAND ST STE 211
FORT WORTH, TX 76107
Electrodiagnostic Medicine
111 BOLAND ST STE 211
FT WORTH, TX 76107
Electrodiagnostic Medicine
111 BOLAND ST STE 211
FT WORTH, TX 76107
Specialist/Technologist, Other (Electroneurodiagnostic)
111 BOLAND ST STE 211
FT WORTH, TX 76107

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Cc1 Medical Holding LLC's NPI number?

The NPI number for Cc1 Medical Holding LLC is 1093423535. It was assigned to this organization in the NPPES registry on November 14, 2022.

Where is Cc1 Medical Holding LLC located?

Cc1 Medical Holding LLC is located at 111 Boland St Ste 211, Ft Worth, TX 76107. The listed phone number is (817) 529-8488.

What is Cc1 Medical Holding LLC's specialty?

The primary specialty registered for this NPI is Electrodiagnostic Medicine with taxonomy code 204R00000X.

When was this NPI record last updated?

The NPPES record for Cc1 Medical Holding LLC was last updated on November 14, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.