# WAY OUT WEST SPINE AND MOBILITY PLLC

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

## Provider details

- **NPI number:** 1942769476
- **Authorized official:** MIKE MARTINEZ II DO (LEAD PHYSICIAN)
- **Authorized official phone:** (682) 285-1044

## Contact information

- **Practice address:** 120 SAINT LOUIS AVE STE 100, FORT WORTH, TX 76104-1256
- **Practice address phone:** (682) 285-1044
- **Practice address fax:** (855) 361-0894
- **Mailing address:** 120 SAINT LOUIS AVE STE 100, FORT WORTH, TX 76104-1256
- **Mailing address phone:** (682) 285-1044
- **Mailing address fax:** (855) 361-0894

## Taxonomy

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

## Other

- **Enumeration date:** 03/14/2019
- **Last updated:** 07/26/2022