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Organization
TEXAS IPM, LLC
Active
Organization
TEXAS IPM, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE BOYD (PRACTICE MANAGER)
(682) 478-8123
Entity
Organization
Contact information
Practice address
416 S HENDERSON ST, FORT WORTH, TX 76104-1017
(682) 478-8123
Mailing address
416 S HENDERSON ST, FORT WORTH, TX 76104-1017
(682) 478-8123
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
—
NULL
207L00000X
Anesthesiology Physician
—
—
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
—
NULL
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
—
—
Other
Enumeration date
03/09/2022
Last updated
03/09/2022
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