Ft. Worth Spinal Decompression Center, P.C.

Primary specialty

Sports Physician ChiropractorTaxonomy code 111NS0005X

License

6533 Issued in TX

Legal business name

FT. WORTH SPINAL DECOMPRESSION CENTER, P.C.

Practice address

1149 Precinct Line Rd Ste a
Hurst, TX 76053-4289

Phone

(817) 284-1235

Fax

(817) 284-1226

NPI assigned

Nov 8, 2010

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Andre Wullaert

Title

Owner

Phone

(817) 284-1235

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1289174400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1289174400000",
    "number": "1003117052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1149 PRECINCT LINE RD STE A",
            "city": "HURST",
            "state": "TX",
            "postal_code": "760534289",
            "telephone_number": "817-284-1235",
            "fax_number": "817-284-1226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1149 PRECINCT LINE RD STE A",
            "city": "HURST",
            "state": "TX",
            "postal_code": "760534289",
            "telephone_number": "817-284-1235",
            "fax_number": "817-284-1226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FT. WORTH SPINAL DECOMPRESSION CENTER, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-08",
        "last_updated": "2010-11-08",
        "status": "A",
        "authorized_official_last_name": "WULLAERT",
        "authorized_official_first_name": "ANDRE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "817-284-1235"
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor, Sports Physician",
            "state": "TX",
            "license": "6533",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Randall Glenn Franklin Jr., RMT
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• George Fritts Jr., LPC
• Frusher Internal Medicine
• Marcy Ann Fuentes, COTA
• Maria Fuentes
• Magan Leigh Fuller, COTA
• Valerie Fusilier, PTA
• Marie Yvette Galvan, PA

• Sports Physician Chiropractor in Hurst, TX
• Providers in Hurst, TX by specialty
• Sports Physician Chiropractor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.