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

Water Leaf Surgery Center Management LLC

Organization Electrodiagnostic Medicine Physician · NPI 1164942157

Water Leaf Surgery Center Management LLC is an Electrodiagnostic Medicine Physician in Ft Worth, Texas. Registered with an NPI since 2017.

In the registry since
2017
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Practice location Address checks out

111 Boland St Ste 211
Ft Worth, TX 76107-1265
Phone: (214) 269-3875
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 number1164942157
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Gina Sullivan — Billing Manager · (214) 269-3875
NPI enumeratedJune 21, 2017
Last updated in NPPESJune 21, 2017
Mailing address5200 Davis Ln Ste B200, Austin, TX 78749-4069

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