KENSINGTON INTERVENTIONAL PAIN CENTER, LLC (NPI# 1104214642) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104214642 |
| Entity Type | Organization |
| Organization Name | KENSINGTON INTERVENTIONAL PAIN CENTER, LLC |
| Practice Address |
1305 Airport Fwy Suite 103 Bedford TX 76021-6605 |
| Mailing Address |
Po Box 674267 Dallas TX 75267-4267 |
| Practice Telephone | 9722344740 |
| Practice Fax Number | 8175710897 |
| Mailing Telephone | 9722344740 |
| Mailing Fax Number | 8175710897 |
| Enumeration Date | 2015-01-07 |
| Last Update Date | 2015-01-07 |
| Authorized Official Name | TRACY WALLS (MANAGER) |
| Authorized Official Telephone | 9722344740 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP3300X |
Clinic/Center Specialization: Pain |
Ambulatory Health Care Facilities |
| Street Address |
1305 AIRPORT FWY SUITE 103 |
| City | BEDFORD |
| State | TX |
| Zip Code | 76021-6605 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952304743 | James Marcellus Barry Jr. | Psychiatry & Neurology | 1305 Airport Fwy, Ste 205, Bedford, TX 76021-6606 | 2005-05-24 |
| 1033636477 | Amanda Dutro | Nurse Practitioner | 1305 Airport Fwy, Bedford, TX 76021-6605 | 2017-08-26 |
| 1811344302 | Cardiac Cath Lab of Mid Cities, Lp | Clinic/Center | 1305 Airport Fwy, Suite 121, Bedford, TX 76021-6605 | 2016-05-16 |
| 1356798854 | Mid Cities Asc, Lp | Clinic/Center | 1305 Airport Fwy, Suite 123, Bedford, TX 76021-6605 | 2016-05-16 |
| 1548644610 | Venkatesan D. Vidi, Md Pllc | Internal Medicine | 1305 Airport Fwy, Ste 421, Bedford, TX 76021-6605 | 2015-07-17 |
| 1801273800 | Manchester Interventional Pain Center LLC | Nurse Anesthetist, Certified Registered | 1305 Airport Fwy, Suite 103, Bedford, TX 76021-6605 | 2015-04-29 |
| 1174917108 | Ashland Interventional Pain Center LLC | Nurse Anesthetist, Certified Registered | 1305 Airport Fwy, Suite 103, Bedford, TX 76021-6605 | 2015-03-27 |
| 1326458191 | Mid-cities Cardiac Care Center, Pllc | Clinic/Center | 1305 Airport Fwy, Suite 421, Bedford, TX 76021-6605 | 2014-05-02 |
| 1700228343 | Fisher Cardiology and Electrophyisology | Internal Medicine | 1305 Airport Fwy, Suite 421, Bedford, TX 76021-6605 | 2013-07-24 |
| 1639412836 | Chart Rehabilitation | Clinic/Center | 1305 Airport Fwy, Suite 402, Bedford, TX 76021-6605 | 2013-04-05 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396357851 | Crystal Le | Pharmacist | 4121 E Hardwood Rd, Bedford, TX 76021 | 2020-08-17 |
| 1114544095 | Morgan Sanders | Physical Therapist | 2419 Tx 121, Bedford, TX 76021 | 2020-06-26 |
| 1669938171 | Tracie Thomas | Nurse Practitioner | 3901 Airport Freeway, Suite 230, Bedford, TX 76021 | 2019-02-20 |
| 1346710928 | Bedford Pharmacy LLC | Pharmacy | 2816 Central Dr Ste 160, Bedford, TX 76021 | 2018-11-27 |
| 1861973562 | Healogix Consultants, LLC | Pharmacy | 601-1 Harwood Rd, Bedford, TX 76021 | 2018-08-22 |
| 1851870570 | Artie Lee Nolen | Licensed Vocational Nurse | 1415 Shady Ln, Bedford, TX 76021 | 2018-08-13 |
| 1821510496 | Gabriela D Driskill | Counselor | 201 E. 9th Street, Dallas, TX 76021 | 2017-07-14 |
| 1588190938 | Tdc-bedford Dialysis Clinic LLC | Clinic/Center | 725 N Industrial Blvd, Ste 100, Bedford, TX 76021 | 2017-05-04 |
| 1801246673 | Tamara Allen-wolf, LLC | Counselor | 2217 Martin Dr., Ste 200, Bedford, TX 76021 | 2016-06-13 |
| 1013399799 | Nirvana Dental | Clinic/Center | 3704 Cheek Sparger Road #100, Bedford, TX 76021 | 2015-06-18 |
| Find all providers in zip 76021 | ||||
| Taxonomy Code | 261QP3300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Pain |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578979753 | Alliance Interventional Pain Center | Clinic/Center | 1305 Airport Fwy Ste 103, Bedford, TX 76021-6603 | 2014-07-08 |
| 1114359353 | Allied Pain and Rehab Specialist | Clinic/Center | 2900 Highway 121, Suite 120, Bedford, TX 76021-4033 | 2013-07-30 |
| 1023379211 | Bedford Interventional Pain Center, LLC | Clinic/Center | 1305 Airport Fwy, Suite 103, Bedford, TX 76021-6605 | 2012-06-04 |
| 1922372713 | Keller Interventional Pain Center, LLC | Clinic/Center | 1305 Airport Fwy, Suite 103, Bedford, TX 76021-6605 | 2012-02-27 |
| 1881965408 | Carroll Interventionalpain Center, LLC | Clinic/Center | 1305 Airport Fwy, Suite 103, Bedford, TX 76021-6605 | 2012-01-13 |
| 1710280839 | Araphaho Interventional Pain Center, LLC | Clinic/Center | 1305 Airport Fwy, Suite 103, Bedford, TX 76021-6605 | 2010-12-11 |
| 1184927204 | Prestonwood Pain Center, LLC | Clinic/Center | 1305 Airport Fwy, Suite 103, Bedford, TX 76021-6605 | 2010-12-11 |
| 1962705079 | Southlake Interventional Pain Center, LLC | Clinic/Center | 1305 Airport Fwy, Suite 103, Bedford, TX 76021-6605 | 2010-12-10 |
| 1033410469 | Davinci Pain Center, LLC | Clinic/Center | 1305 Airport Fwy, Suite 103, Bedford, TX 76021-6605 | 2010-11-17 |
| 1376857912 | Harwood Pain Center LLC | Clinic/Center | 1305 Airport Fwy, Suite 103, Bedford, TX 76021-6605 | 2010-08-05 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.