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

Detoelarization LLC

Organization Electrodiagnostic Medicine Physician · NPI 1376195172

Detoelarization LLC is an Electrodiagnostic Medicine Physician in Fort Worth, Texas. Registered with an NPI since 2019.

In the registry since
2019
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

111 Boland St Ste 211
Fort Worth, TX 76107-1265
Phone: (817) 529-8488
Fax: (903) 328-6568
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Electrodiagnostic Medicine Physician (primary) Taxonomy 204R00000X

Record details

NPI number1376195172
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Gina Sullivan — Billing Manager · (817) 529-8488
NPI enumeratedJuly 11, 2019
Last updated in NPPESJuly 11, 2019
Mailing address111 Boland St Ste 211, Fort Worth, TX 76107-1265

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