Organization
BLUE STAR PAIN CENTER,LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAVI PATEL MD (OWNER)
(817) 874-0926
Entity
Organization
Contact information
Practice address
6913 CAMP BOWIE BLVD STE 173, FORT WORTH, TX 76116-7169
(817) 510-8880
(817) 510-8881
Mailing address
6913 CAMP BOWIE BLVD STE 173, FORT WORTH, TX 76116-7169
(817) 510-8880
(817) 510-8881
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
06/13/2024
Last updated
01/20/2025
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