Old Baytown LLC
Old Baytown LLC is an Electrodiagnostic Medicine Physician in Ft Worth, Texas. Registered with an NPI since 2022.
- In the registry since
- 2022
What do these letters mean?
- LLC — Limited liability company
- A form of business registration, not a clinical qualification.
Practice location Address checks out
111 Boland St Ste 211Ft 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 number | 1679281885 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Gina Sullivan — Practice Administrator · (903) 259-0550 |
| NPI enumerated | November 8, 2022 |
| Last updated in NPPES | January 17, 2023 |
| Certification date | January 17, 2023 |
| Mailing address | 111 Boland St Ste 211, Ft Worth, TX 76107-1265 |
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