Healthport P.A.
Physical Medicine & Rehabilitation, Pain Medicine in Tyler, TX. Organization (NPI-2).
Details
- NPI
- 1154577641
- Entity type
- Organization (NPI-2)
- Legal business name
- Healthport P.A.
- Organization subpart
- No
- Enumeration date
- Aug 15, 2008
- Last updated
- Jan 7, 2013
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2081P2900X | Physical Medicine & Rehabilitation, Pain Medicine | – | – | Yes |
| 111N00000X | Chiropractor | – | – | |
| 208VP0014X | Pain Medicine, Interventional Pain Medicine | – | – |
Other names
- Pain Recovery Center Of Tyler (Doing Business As)
Practice location
4295 Kinsey DrTyler, TX 75703-1004
Phone 903-526-5000 · Fax 903-526-5006
Mailing address
4295 Kinsey DrTyler, TX 75703-1004
Phone 903-526-5000 · Fax 903-526-5006
Authorized official
Kenneth Fults
President
9035265000
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
Other Pain Medicine (Physical Medicine & Rehabilitation) Physician providers in Tyler, TX
- Ameer Syed Ali, D.O.NPI 1982065561
- Jonathan Blau, M.D.NPI 1942260567
- Jonathan Blau MD PANPI 1073653820
- Scott Joseph Lamb, M.D.NPI 1831192277
- Barbara Jean Sigal, MDNPI 1790883239
All 6 Pain Medicine (Physical Medicine & Rehabilitation) Physician providers in Tyler · All 6,843 providers in Tyler
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