Organization
NIRVANA IONM PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GINA SULLIVAN (PRACTICE ADMINISTRATOR)
(903) 259-0550
Entity
Organization
Contact information
Practice address
4455 CAMP BOWIE BLVD # 114-67, FT WORTH, TX 76107-3826
(817) 529-8488
(903) 328-6568
Mailing address
4455 CAMP BOWIE BLVD # 114-67, FT WORTH, TX 76107-3826
(817) 529-8488
(903) 328-6568
Taxonomy
Speciality
Code
Description
License number
State
246ZE0600X
Electroneurodiagnostic Specialist/Technologist
Primary
—
—
Other
Enumeration date
04/21/2026
Last updated
04/21/2026
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