OrganizationActive
Baseline Diagnostic
NPI 1023578929 · Electrodiagnostic Medicine Physician · Ft Worth, TX
Provider details
- NPI number
- 1023578929
- Entity type
- Organization
- Primary specialty
- Electrodiagnostic Medicine PhysicianAllopathic & Osteopathic Physicians
- Authorized official
- Gina Sullivan, Billing Manager
Practice location
111 Boland St Ste 211
Ft Worth, TX 76107-1265
Phone: (817) 529-8488
Fax: (903) 328-6568
Mailing address
Po Box 25403
Los Angeles, CA 90025-0403
Registry dates
- Enumerated
- 2019-03-25
- Last updated
- 2019-03-25
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.