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HEALTHPORT P.A. NPI 1154577641


NPI Information

NPI: 1154577641
Provider Name: HEALTHPORT P.A.

Doing Business As: PAIN RECOVERY CENTER OF TYLER

Classification: Physical Medicine & Rehabilitation - 2081P2900X
Entity Type: Organization

Specialization: Pain Medicine

Address:
4295 KINSEY DR
TYLER, TX
ZIP 75703
Phone: (903) 526-5000
Get Directions

HEALTHPORT P.A. is a pain medicine physical medicine rehabilitation in Tyler, TX. The provider is a physician who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic or cancer pain in both hospital and ambulatory settings. Patient care needs may also be coordinated with other specialists. HEALTHPORT P.A. NPI is 1154577641. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Pain Recovery Center Of Tyler.

The provider's business location address is:

4295 KINSEY DR
TYLER, TX
ZIP 75703-004
Phone: (903) 526-5000
Fax: (903) 526-5006

The provider's authorized official is Kenneth Fults .
The authorized official title is President and has the following contact phone number (903) 526-5000.

The enumeration date for this NPI number is 8/15/2008 and was last updated on 1/7/2013.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1111N00000XChiropractorNo
2208VP0014XPain MedicineInterventional Pain MedicineNo
32081P2900XPhysical Medicine & RehabilitationPain MedicineYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
10A3444MEDICARE PINTEXAS
20066SGOTHERTEXASBCBS
3208679501MEDICAIDTEXAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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