Organization Active NPI

Bio-Optimized Body LLC

  • Health Service Clinic/Center
  • Southlake, TX
National Provider Identifier
1255242269
Registry record updated Sep 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service Clinic/CenterTaxonomy code 261QH0100X
Legal business name
BIO-OPTIMIZED BODY LLC
Practice address
360 N. Kimball Ave
Ste. 110
Southlake, TX 76092
Phone
(817) 313-7474
Fax
(817) 410-9699
NPI assigned
Sep 16, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2026

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

Authorized official

Name
Dr. Robert Eugene Bayless, MD
Title
Medical Director
Phone
(214) 287-3888

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Clinic/Center 261QH0100X Primary

Addresses

Primary practice location

360 N. Kimball Ave
Ste. 110
Southlake, TX 76092

Mailing address

360 N. Kimball Ave
Ste. 110
Southlake, TX 76092
Phone (817) 313-7474

NPI Registry JSON

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

{
    "created_epoch": "1789516800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1789516800000",
    "number": "1255242269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 N. KIMBALL AVE",
            "address_2": "STE. 110",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "76092",
            "telephone_number": "817-313-7474",
            "fax_number": "817-410-9699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 N. KIMBALL AVE",
            "address_2": "STE. 110",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "76092",
            "telephone_number": "817-313-7474",
            "fax_number": "817-410-9699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BIO-OPTIMIZED BODY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-09-16",
        "last_updated": "2026-09-16",
        "certification_date": "2026-09-15",
        "status": "A",
        "authorized_official_last_name": "BAYLESS",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "EUGENE",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "214-287-3888",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southlake, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.