Provider Demographics
NPI:1326475344
Name:NEUROPATHY PAIN CLINIC OF FORT WORTH
Entity Type:Organization
Organization Name:NEUROPATHY PAIN CLINIC OF FORT WORTH
Other - Org Name:DFW NEUROPATHY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALI
Authorized Official - Middle Name:HOSSEINI
Authorized Official - Last Name:ALAVI
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:972-931-3131
Mailing Address - Street 1:3750 S UNIVERSITY DR
Mailing Address - Street 2:STE. 202
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76109-3795
Mailing Address - Country:US
Mailing Address - Phone:817-924-1000
Mailing Address - Fax:817-924-1001
Practice Address - Street 1:6210 CAMPBELL RD
Practice Address - Street 2:STE. 225
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75248-1379
Practice Address - Country:US
Practice Address - Phone:972-931-3131
Practice Address - Fax:972-931-3132
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-04
Last Update Date:2013-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies