NPIMap

Organization Active NPI

FW Interventional Pain Center, LLC

  • Pain Clinic/Center
  • Ft Worth, TX
National Provider Identifier
1285077206
Registry record updated Apr 9, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Clinic/CenterTaxonomy code 261QP3300X
Legal business name
FW INTERVENTIONAL PAIN CENTER, LLC
Practice address
1201 Summit Ave
Suite 400
Ft Worth, TX 76102-4413
Phone
(817) 334-0990
Fax
(817) 571-0897
NPI assigned
Apr 9, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2013

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

Authorized official

Name
Tracy Walls
Title
President
Phone
(972) 234-4740

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Clinic/Center 261QP3300X Primary

Addresses

Primary practice location

1201 Summit Ave
Suite 400
Ft Worth, TX 76102-4413

Mailing address

PO Box 674354
Dallas, TX 75267-4354
Phone (972) 479-1115

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1365465600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1365465600000",
    "number": "1285077206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 674354",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752674354",
            "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": "1201 SUMMIT AVE",
            "address_2": "SUITE 400",
            "city": "FT WORTH",
            "state": "TX",
            "postal_code": "761024413",
            "telephone_number": "817-334-0990",
            "fax_number": "817-571-0897"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FW INTERVENTIONAL PAIN CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-09",
        "last_updated": "2013-04-09",
        "status": "A",
        "authorized_official_last_name": "WALLS",
        "authorized_official_first_name": "TRACY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "972-234-4740"
    },
    "taxonomies": [
        {
            "code": "261QP3300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Pain",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ft Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2013; 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.