NPI Code Details Logo

NPI 1952234205

NPI 1952234205 : LIV SPECIALTY CARE TX, P.C. : FORT WORTH, TX

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1952234205
-----------------------------------------------------
    Entity Type          |    Organization 
-----------------------------------------------------
    Legal Business Name  |    LIV SPECIALTY CARE TX, P.C. 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    06/05/2026
-----------------------------------------------------
    Last Update Date     |    06/05/2026
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    9435 NORTH FWY 
-----------------------------------------------------
    City                 |    FORT WORTH
-----------------------------------------------------
    State                |    TX
-----------------------------------------------------
    Zip                  |    76177-7623
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    817-842-1564
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    4900 CENTENNIAL BLVD STE 300 
-----------------------------------------------------
    City                 |    NASHVILLE
-----------------------------------------------------
    State                |    TN
-----------------------------------------------------
    Zip                  |    37209-1105
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    844-509-1404
-----------------------------------------------------
    Fax                  |    844-278-8635
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    CEO
-----------------------------------------------------
    Name                 |     WOODRUFF  BAUM 
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    646-568-0193
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    208VP0014X
-----------------------------------------------------
    Taxonomy Name        |    Interventional Pain Medicine Physician
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
    Taxonomy Code        |    261QI0500X
-----------------------------------------------------
    Taxonomy Name        |    Infusion Therapy Clinic/Center
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------



                        

Copyright © 2007-2026 Data Labs Health. All rights reserved.