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NPI Code Detail

MEDICARE: HEALTHTEXAS PROVIDER NETWORK

MEDICARE: HEALTHTEXAS PROVIDER NETWORK
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
1208000000XPediatrics Physician00249NTX
2207R00000XInternal Medicine Physician00249NTX
3207RP1001XPulmonary Disease Physician00249NTX
4207Q00000XFamily Medicine Physician00249NTX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
200249NOTHERTXBCBSTX

General Provider Information

NPI Number : 1063417699
Entity Type Code : Organization
Provider Name (Legal Business Name) : HEALTHTEXAS PROVIDER NETWORK
Provider Business Mailing Address
First Line : 8080 N CENTRAL EXPY
Second Line : STE 600, LB82
City : DALLAS
State : TX
Zip : 75206-1838
Country : US
Telephone Number : 972-860-8648
Fax Number : 972-860-8679
Provider Business Practice Location Address
First Line : 200 N VIRGINIA ST
Second Line :
City : TERRELL
State : TX
Zip : 75160-2732
Country : US
Telephone Number : 972-551-7500
Fax Number : 972-524-7418
Authorized Official
Title or Position : DIRECTOR
Name : MRS. ELLEN ELIZABETH FOURTON
Credential :
Telephone Number : 972-860-8649
Provider Enumeration Date : 06/20/2005
Last Update Date : 04/20/2010

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1851318539 — JUDY L CANDLER MSN, GNP
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1366463887 — MARY E CARVER MSN
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Directions to “HEALTHTEXAS PROVIDER NETWORK ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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