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

Vacquero Medical 1 PA

Organization Electrodiagnostic Medicine Physician · NPI 1538843842

Vacquero Medical 1 PA is an Electrodiagnostic Medicine Physician in Ft Worth, Texas. Registered with an NPI since 2023.

In the registry since
2023
What do these letters mean?
PA — Professional association
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) 529-8511
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 number1538843842
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Gina Sullivan — Practice Administrator · (903) 259-0550
NPI enumeratedJune 15, 2023
Last updated in NPPESJune 15, 2023
Certification dateJune 15, 2023
Mailing address111 Boland St Ste 211, Ft Worth, TX 76107-1265

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