National Provider Identifier Database

HEALTHPORT PA
Pain Medicine

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.


Contact Information

HEALTHPORT P.A.
4295 KINSEY DR
TYLER, TX75703-1004
Phone: 903-526-5000
Fax: 903-526-5006
Website:
Specialty Taxonomy Code
* Pain Medicine 2081P2900X
Chiropractor 111N00000X
Interventional Pain Medicine 208VP0014X

* Indicates primary specialty

NPI Profile & details for HEALTHPORT P.A.

NPI Number 1154577641
Legal business name
LBN
HEALTHPORT P.A.
Authorized official KENNETH FULTS - (PRESIDENT)
Entity Organization
Organization subpart No
Enumeration date 08/15/2008
Last updated 01/07/2013 - About 13 years ago
Sole proprietor1 Not specified
Identifiers
  • TX Medicaid: 208679501
  • TX Other: 0066SG BCBS

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

Reviews for HEALTHPORT P.A.

There are currently no reviews for HEALTHPORT P.A.


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