Bedford Interventional Pain Center, LLC

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

Legal business name

BEDFORD INTERVENTIONAL PAIN CENTER, LLC

Practice address

1305 Airport Fwy
Suite 103,
Bedford, TX 76021-6605

Phone

(972) 234-4740

Fax

(817) 571-0897

NPI assigned

Jun 4, 2012

Last updated

Jun 6, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Tracy Walls

Title

Manager

Phone

(972) 234-4740

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1338768000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1465171200000",
    "number": "1023379211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 674160",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752674160",
            "telephone_number": "972-479-1115",
            "fax_number": "972-346-8015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1305 AIRPORT FWY",
            "address_2": "SUITE 103,",
            "city": "BEDFORD",
            "state": "TX",
            "postal_code": "760216605",
            "telephone_number": "972-234-4740",
            "fax_number": "817-571-0897"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEDFORD INTERVENTIONAL PAIN CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-04",
        "last_updated": "2016-06-06",
        "status": "A",
        "authorized_official_last_name": "WALLS",
        "authorized_official_first_name": "TRACY",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "972-234-4740"
    },
    "taxonomies": [
        {
            "code": "261QP3300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Pain",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Bedford Family Medicine, PA
• Bedford Gardens Limited Partnership (Eden Estates)
• Bedford Medical Associates
• Bedford Operations, LLC (Elmcroft of Bedford)
• Bedford Pharmacy LLC (Bedford Pharmacy)
• Bedford Surgery Center LLC
• Ryan T Beelman, D.M.D.

• Certified Registered Nurse Anesthetist in Bedford, TX
• Providers in Bedford, TX by specialty
• Certified Registered Nurse Anesthetist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2016; 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.