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

Phase Reversal LLC

Organization Electrodiagnostic Medicine Physician · NPI 1407409485

Phase Reversal LLC is an Electrodiagnostic Medicine Physician in Ft 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
Ft 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 number1407409485
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Gina Sullivan — Billing Manager · (817) 529-8488
NPI enumeratedJuly 19, 2019
Last updated in NPPESJuly 19, 2019
Mailing address111 Boland St Ste 211, Ft Worth, TX 76107-1265

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