Pain Recovery Center Of Tyler
LBN: Healthport P.A.
Pain Recovery Center Of Tyler is an health care organization with primary practice located at 4295 Kinsey Dr , Tyler TX 75703-1004. The organization recently has 3 registered licenses in different health care specialties including Chiropractic Providers / Chiropractor, Allopathic & Osteopathic Physicians / Pain Medicine, Allopathic & Osteopathic Physicians / Interventional Pain Medicine. Allopathic & Osteopathic Physicians / Pain Medicine is the primary health care specialty.
Healthport P.A. can be contacted via phone (903) 526-5000, or through Fults, Kenneth via phone (903) 526-5000.
Contact Information
Primary practice address
4295 Kinsey Dr
Tyler TX 75703-1004
Phone: (903) 526-5000
Fax: (903) 526-5006
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Chiropractic Providers / Chiropractor | 111N00000X | ||
| Allopathic & Osteopathic Physicians / Pain Medicine | 2081P2900X | ||
| Allopathic & Osteopathic Physicians / Interventional Pain Medicine | 208VP0014X |
Profile Details
| NPI number | 1154577641 |
|---|---|
| LBN Legal business name | Healthport P.A. |
| DBA Doing business as | Pain Recovery Center Of Tyler |
| Authorized official | Fults, Kenneth Doctor of Osteopathy (DO) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Aug 15th, 2008 |
| Last updated | Jan 7th, 2013 - about 11 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1154577641 | NPPES |
| Texas | MEDICAID | 208679501 | |
| Texas | Other | 0066SG |
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