# BEVERLY HILLS PAIN MANAGEMENT

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1104581800
- **Authorized official:** DR. KENNETH M YAKER MD (OWNER)
- **Authorized official phone:** (817) 926-5800

## Contact information

- **Practice address:** 3019 SOUTH FWY, FORT WORTH, TX 76104-7234
- **Practice address phone:** (323) 868-8099
- **Mailing address:** 3019 SOUTH FWY, FORT WORTH, TX 76104-7234
- **Mailing address phone:** (323) 868-8099

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | — | NULL | Yes |
| 208D00000X | General Practice Physician | — | — | Yes |

## Other

- **Enumeration date:** 11/08/2021
- **Last updated:** 11/08/2021