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Liberty Iom LLC

Electrodiagnostic Medicine Physician in Ft Worth, TX · enumerated 2022 · authorized official Gina Sullivan, Practice Administrator.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1093450975

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Registry record

Entity type Organization (Type 2)
Legal business name Liberty Iom LLC
Practice address 111 Boland St Ste 211, Ft Worth, TX, 76107
Phone (817) 529-8488
Fax (903) 328-6568
Enumeration date May 4, 2022
Last updated in NPPES May 4, 2022

Taxonomy & classification

204R00000X Electrodiagnostic Medicine Physician Allopathic & Osteopathic Physicians Primary

Authorized official

Name Gina Sullivan
Title Practice Administrator
Phone (903) 259-0550

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

Who is the authorized official for Liberty Iom LLC?
NPPES lists Gina Sullivan (Practice Administrator) as the authorized official for this organization.
What is the NPI number for Liberty Iom LLC?
The NPI for Liberty Iom LLC is 1093450975, a Type 2 (organization) record in the CMS NPPES registry.

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2022-05-04.