# OLYMPUS PAIN AND ORTHOPEDICS

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

## Provider details

- **NPI number:** 1780195412
- **Authorized official:** SHERRY ALONZO (MANGER)
- **Authorized official phone:** (469) 998-2400

## Contact information

- **Practice address:** 1001 12TH AVE STE 154, FORT WORTH, TX 76104-3929
- **Practice address phone:** (469) 998-2400
- **Practice address fax:** (469) 998-2401
- **Mailing address:** 1001 12TH AVE STE 154, FORT WORTH, TX 76104-3929
- **Mailing address phone:** (469) 998-2400
- **Mailing address fax:** (469) 998-2401

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | Q8858 | TX | Yes |

## Other

- **Enumeration date:** 10/20/2017
- **Last updated:** 10/20/2017