MEDICARE: OP SERVICES LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	246ZE0600X	Electroneurodiagnostic Specialist/Technologist

General Provider Information

NPI Number	:	1477483691
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OP SERVICES LLC

Provider Business Mailing Address
First Line	:	4455 CAMP BOWIE BLVD # 114-67
Second Line	:
City	:	FT WORTH
State	:	TX
Zip	:	76107-3826
Country	:	US
Telephone Number	:	817-529-8488
Fax Number	:	903-328-6568

Provider Business Practice Location Address
First Line	:	4455 CAMP BOWIE BLVD # 114-67
Second Line	:
City	:	FT WORTH
State	:	TX
Zip	:	76107-3826
Country	:	US
Telephone Number	:	817-529-8488
Fax Number	:	903-328-6568

Authorized Official
Title or Position	:	PRACTICE ADMINISTRATOR
Name	:	GINA SULLIVAN
Credential	:
Telephone Number	:	903-259-0550

Provider Enumeration Date	:	05/20/2026
Last Update Date	:	05/20/2026

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Directions to “OP SERVICES LLC ” Practice Location

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