TEXAS WELLNESS AND PAIN CENTER PLLC – Pain Medicine (Physical Medicine & Rehabilitation) Physician, NPI 1427522309
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Main info
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Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for TEXAS WELLNESS AND PAIN CENTER PLLC
1004 STERLING TRACE DR
MANSFIELD, TX 760632296
Phone: (817) 666-0556
Type: Mailing
Bryant Irvin Road, Fort Worth, Tarrant County, Texas, 76132, United States
FORT WORTH, TX 761323631
Phone: (469) 697-9545
Fax: (469) 697-9548
Type: Location
2507 MEDICAL ROW STE 102
GRAND PRAIRIE, TX 750511070
Phone: (817) 784-7500
Fax: (817) 784-7600
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2019-05-28
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2024-06-30 (709 days ago).
Enrollment records
2
Earliest due date
2024-06-30
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| O20190314000385 | O | Clinic/Group Practice | TX | 2024-06-30 |
| O20190528001697 | O | Physician - Unknown Physician Specialty | TX | 2026-09-30 |
What to do next
- Verify current status on the CMS Revalidation Lookup Tool immediately.
- Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
- Overdue revalidation can lead to deactivation of Medicare billing privileges.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 76063)
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