WAY OUT WEST SPINE AND MOBILITY PLLC
NPI 1942769476
Anesthesiology - Pain Medicine in Fort Worth, TX

Active since March 14, 2019
120 SAINT LOUIS AVE STE 100, FORT WORTH, TX 76104(682) 285-1044(855) 361-0894 Get Directions Write a Review

NPPES record last updated: July 26, 2022. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Jul 26, 2022, Mar 20, 2019, Mar 14, 2019 (3 updates tracked since 2019).

  • Organization
  • Anesthesiology
  • Pain Medicine

About WAY OUT WEST SPINE AND MOBILITY PLLC

This page provides the complete NPI Profile along with additional information for Way Out West Spine And Mobility Pllc, a provider established in Fort Worth, Texas operating as a Anesthesiology, focusing in pain medicine . The healthcare provider is registered in the NPI registry with number 1942769476 assigned on March 2019. The practitioner's primary taxonomy code is 207LP2900X. The provider is registered as an organization and their NPI record was last updated 4 years ago. Way Out West Spine And Mobility Pllc operates as a Multi-Specialty Group with one or more individual practitioners, who practice different areas of specialization. The authorized official of this NPI record is Mike Martinez Ii Do (Lead Physician)

NPI
1942769476 Verify this NPI
Provider Name
WAY OUT WEST SPINE AND MOBILITY PLLC
Entity Type
Organization
Location Address
120 SAINT LOUIS AVE STE 100 FORT WORTH, TX 76104
Location Phone
(682) 285-1044
Location Fax
(855) 361-0894
Mailing Address
120 SAINT LOUIS AVE STE 100 FORT WORTH, TX 76104
Mailing Phone
(682) 285-1044
Mailing Fax
(855) 361-0894
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
03-14-2019
Last Update Date
07-26-2022
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Anesthesiology Pain Medicine

Taxonomy Code
207LP2900X
Type
Allopathic & Osteopathic Physicians
Taxonomy Description
An anesthesiologist who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic and/or cancer pain in both hospital and ambulatory settings. Patient care needs are also coordinated with other specialists.

Group Taxonomy 193200000X MULTI-SPECIALTY GROUP

This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

MIKE MARTINEZ II DO

Authorized Official Title
LEAD PHYSICIAN
Authorized Official Phone
(682) 285-1044

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Other Providers at the Same Location


The following 2 providers are registered at the same or a nearby location.

Pain Medicine (Interventional Pain Medicine)
120 SAINT LOUIS AVE STE 100
FORT WORTH, TX 76104
Physical Medicine & Rehabilitation
120 SAINT LOUIS AVE STE 100
FORT WORTH, TX 76104

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1942769476, enumerated as an "organization" on March 14, 2019.

The provider is located at 120 SAINT LOUIS AVE STE 100 FORT WORTH, TX 76104 and the phone number is (682) 285-1044.

Anesthesiology with taxonomy code 207LP2900X and a focus in Pain Medicine.