SPINE PAIN NM LLC
NPI 1902405657
Electrodiagnostic Medicine in Ft Worth, TX

Active since October 23, 2020
111 BOLAND ST STE 211, FT WORTH, TX 76107(817) 529-8488 Get Directions Write a Review

NPPES record last updated: October 23, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Spine Pain Nm Llc NPPES

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

SPINE PAIN NM LLC (NPI 1902405657) is a healthcare organization registered as an electrodiagnostic medicine in Ft Worth, Texas and active in the NPI registry since October 2020. The organization lists Gina Sullivan, Practice Administratoe, as its authorized official.

NPPES Registry Identity

NPI1902405657
Entity TypeOrganization
Primary Taxonomy204R00000X
Legal Business NameSPINE PAIN NM LLC
Location Address111 BOLAND ST STE 211Ft Worth, TX 76107-1265
Mailing Address111 Boland St Ste 211Ft Worth, TX 76107-1265 · (817) 529-8488
Organization SubpartNo
Authorized OfficialGina SullivanPractice Administratoe · (903) 259-0550
Enumeration DateOctober 23, 2020
NPPES CertifiedOctober 23, 2020
NPI 1902405657 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 Spine Pain Nm LLC's NPI number?

The NPI number for Spine Pain Nm LLC is 1902405657. It was assigned to this organization in the NPPES registry on October 23, 2020.

Where is Spine Pain Nm LLC located?

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

What is Spine Pain Nm 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 Spine Pain Nm LLC was last updated on October 23, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.