Baseline Diagnostic

Electrodiagnostic Medicine Physician · Ft Worth, TX

Organization Active NPI

NPI number 1023578929

Practice location

111 Boland St Ste 211
Ft Worth, TX 76107-1265
Phone
(817) 529-8488
Fax
(903) 328-6568

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NPI record

NPI
1023578929
Entity type
Organization (Type 2)
Enumeration date
March 25, 2019
Last updated
March 25, 2019
Organization subpart
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Electrodiagnostic Medicine Physician Primary 204R00000X — —

Mailing address

PO Box 25403
Los Angeles, CA 90025-0403

Authorized official

Name
Gina Sullivan
Title
Billing Manager
Phone
(817) 529-8488

About Baseline Diagnostic

Baseline Diagnostic is a healthcare organization registered in the NPI registry with the primary taxonomy Electrodiagnostic Medicine Physician (code 204R00000X). The practice location is 111 Boland St Ste 211, Ft Worth, TX 76107-1265. The NPI number 1023578929 was assigned on March 25, 2019 and the record was last updated on March 25, 2019.

The authorized official for this organization is Gina Sullivan, Billing Manager.

Frequently asked questions

What is the NPI number of Baseline Diagnostic?

The NPI number is 1023578929.

What is the phone number of Baseline Diagnostic?

The phone number listed for the practice location is (817) 529-8488.

Where is Baseline Diagnostic located?

111 Boland St Ste 211, Ft Worth, TX 76107-1265.

What is the taxonomy code for Baseline Diagnostic?

The primary taxonomy code is 204R00000X – Electrodiagnostic Medicine Physician.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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