Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Baseline Diagnostic

Organization Electrodiagnostic Medicine Physician · NPI 1023578929

Baseline Diagnostic is an Electrodiagnostic Medicine Physician in Ft Worth, Texas. Registered with an NPI since 2019.

In the registry since
2019

Practice location Address checks out

111 Boland St Ste 211
Ft Worth, TX 76107-1265
Phone: (817) 529-8488
Fax: (903) 328-6568
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Electrodiagnostic Medicine Physician (primary) Taxonomy 204R00000X

Record details

NPI number1023578929
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Gina Sullivan — Billing Manager · (817) 529-8488
NPI enumeratedMarch 25, 2019
Last updated in NPPESMarch 25, 2019
Mailing addressPo Box 25403, Los Angeles, CA 90025-0403

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