OrganizationActive
Grapevineverse Iom LLC
NPI 1780149922 · Surgical Technologist · Fort Worth, TX
Provider details
- NPI number
- 1780149922
- Entity type
- Organization
- Primary specialty
- Surgical TechnologistTechnologists, Technicians & Other Technical Service Providers
- Organization subpart
- No
- Authorized official
- Augusto Lastimosa, Managing Member(817) 366-4777
Specialties & taxonomies
Technologists, Technicians & Other Technical Service Providers
Profile Score
Established profile(66/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
7 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
500 Throckmorton Street
Unit 3309
Fort Worth, TX 76102
Phone: (817) 908-8124
Fax: (817) 885-7339
Street-level locationGet directions
Mailing address
500 Throckmorton Street
Fort Worth, TX 76102
Registry dates
- Enumerated
- 2019-02-01
- Last updated
- 2019-02-01
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.