SP 1 MEDICAL HOLDING LLC (NPI# 1538711338) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538711338 |
| Entity Type | Organization |
| Organization Name | SP 1 MEDICAL HOLDING LLC |
| Practice Address |
111 Boland St Ste 211 Fort Worth TX 76107-1265 |
| Practice Telephone | 8175298488 |
| Practice Fax Number | 9033286568 |
| Mailing Telephone | 8175298488 |
| Mailing Fax Number | 9033286568 |
| Enumeration Date | 2019-07-11 |
| Last Update Date | 2019-07-11 |
| Authorized Official Name | GINA SULLIVAN (BILLING MANAGER) |
| Authorized Official Telephone | 8175298488 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 204R00000X | Electrodiagnostic Medicine | Allopathic & Osteopathic Physicians |
| Street Address |
111 BOLAND ST STE 211 |
| City | FORT WORTH |
| State | TX |
| Zip Code | 76107-1265 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376195172 | Detoelarization LLC | Electrodiagnostic Medicine | 111 Boland St Ste 211, Fort Worth, TX 76107-1265 | 2019-07-11 |
| 1952889198 | Narciso Gonzalez Md Pllc | Electrodiagnostic Medicine | 111 Boland St Ste 211, Fort Worth, TX 76107-1265 | 2018-07-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629683602 | Renovo Wound and Hyperbarics Pllc | Emergency Medicine | 5668 Edwards Ranch Road, Suite 101, Fort Worth, TX 76107 | 2020-09-15 |
| 1669085437 | Ryan Bourgeois | Nurse Practitioner | 2917 Crocket Street, Fort Worth, TX 76107 | 2020-08-31 |
| 1053920546 | Christa Marie Widjaja | Optometrist | 1700 Montgomery St, Fort Worth, TX 76107 | 2020-07-30 |
| 1093351355 | Raymond Iannone | Pharmacist | 850 Montgomery St, Suite #310, Fort Worth, TX 76107 | 2019-11-21 |
| 1053963744 | Cumulus Injury Resolution, Inc. | Chiropractor | 4936 Byers Avenue, Fort Worth, TX 76107 | 2019-07-12 |
| 1770135576 | Shadia Osakwe | Physician Assistant | 855 Montgomery Street, Pediatric Clinic, Fort Worth, TX 76107 | 2019-07-11 |
| 1568945442 | Sachin P Patel | Physical Therapist | 4825 Wellesley St, Fort Worth, TX 76107 | 2018-09-07 |
| 1023594025 | Ftw Pharmacy Services Inc | Durable Medical Equipment & Medical Supplies | 2912 W 6th St Ste 150, Fort Worth, TX 76107 | 2018-07-13 |
| 1669974325 | Helen Williamson Elliott | Counselor | 1751 River Run #217, Fort Worth, TX 76107 | 2018-03-08 |
| 1487156931 | Pelvic Neuromonitoring Pllc | Electrodiagnostic Medicine | 111 Boland St #211, Ft Worth, TX 76107 | 2018-03-01 |
| Find all providers in zip 76107 | ||||
| Taxonomy Code | 204R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Electrodiagnostic Medicine |
| Electrodiagnostic medicine is the medical subspecialty that applies neurophysiologic techniques to diagnose, evaluate, and treat patients with impairments of the neurologic, neuromuscular, and/or muscular systems. Qualified physicians are trained in performing electrophysiological testing and interpretation of the test data. They require knowledge in anatomy, physiology, kinesiology, histology, and pathology of the brain, spinal cord, autonomic nerves, cranial nerves, peripheral nerves, neuromuscular junction, and muscles. They must know clinical features and treatment of diseases of the central, peripheral, and autonomic nervous systems, as well as those of neuromuscular junction and muscle. Physicians also require special knowledge about electric signal processing, including waveform analysis, electronics and instrumentation, stimulation and recording equipment, and statistics. |
| Notes: Source: American Association of Neuromuscular & Electrodiagnostic Medicine, 2011. www.aanem.org [1/1/2011: new] Additional Resources: American Board of Electrodiagnostic Medicine, 2011. www.abemexam.org |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144679069 | Collin County Neuromonitoring, Pllc | Electrodiagnostic Medicine | 6080 S Hulen St Ste 360, #176, Fort Worth, TX 76132-4810 | 2016-06-10 |
| 1376195172 | Detoelarization LLC | Electrodiagnostic Medicine | 111 Boland St Ste 211, Fort Worth, TX 76107-1265 | 2019-07-11 |
| 1952889198 | Narciso Gonzalez Md Pllc | Electrodiagnostic Medicine | 111 Boland St Ste 211, Fort Worth, TX 76107-1265 | 2018-07-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053911347 | Sjel Diagnostics of Austin, Pllc | Electrodiagnostic Medicine | 3800 North Lamar Blvd Suite 200, Austin, TX 78756 | 2020-10-27 |
| 1124639752 | Lemongs, Pllc | Electrodiagnostic Medicine | 2313 Lockhill Selma Rd # 179, San Antonio, TX 78230-3007 | 2020-08-17 |
| 1740801612 | Nerve Con LLC | Electrodiagnostic Medicine | 3526 Lakeview Pkwy # B258, Rowlett, TX 75088-4176 | 2020-05-02 |
| 1619503018 | Neuro Gold, Pllc | Electrodiagnostic Medicine | 1819 N Main Ave Ste 215, San Antonio, TX 78212-3941 | 2020-03-17 |
| 1447880026 | Titan Spine, Pllc | Electrodiagnostic Medicine | 675 Town Square Blvd Ste 2001a, Garland, TX 75040-2992 | 2020-01-22 |
| 1699314922 | Rocket Iom, Pllc | Electrodiagnostic Medicine | 3526 Lakeview Pkwy Ste B230, Rowlett, TX 75088-4176 | 2020-01-03 |
| 1861031783 | Ker Rock Island, Pllc | Electrodiagnostic Medicine | 15950 Dallas Pkwy Ste 400, Dallas, TX 75248-6628 | 2019-12-23 |
| 1801434329 | Bc Diagnostics | Electrodiagnostic Medicine | 905 Oak Dr, Flower Mound, TX 75028-1414 | 2019-12-16 |
| 1689211211 | Barton Springs Neurology, Pllc | Electrodiagnostic Medicine | 12030 Bandera Rd # 108-1000, Helotes, TX 78023-4735 | 2019-12-02 |
| 1639714306 | Synaptic Waves LLC | Electrodiagnostic Medicine | 4491 Long Prairie Rd Ste 550, Flower Mound, TX 75028-1795 | 2019-11-16 |
| Find all providers with the same taxonomy | ||||
| City | FORT WORTH |
| Zip Code | 76107 |
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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.