MEDICARE: HEALTH TEXAS 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
1	261QR1300X	Rural Health Clinic/Center

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	CP0098	OTHER	TX	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	008EE	OTHER	TX	BCBS GROUP
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1174747950
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEALTH TEXAS PROVIDER NETWORK

Provider Business Mailing Address
First Line	:	PO BOX 844128
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75284-4128
Country	:	US
Telephone Number	:	469-800-3524
Fax Number	:	469-800-3564

Provider Business Practice Location Address
First Line	:	801 W MAIN ST
Second Line	:
City	:	GUN BARREL CITY
State	:	TX
Zip	:	75156-5312
Country	:	US
Telephone Number	:	903-887-6252
Fax Number	:

Authorized Official
Title or Position	:	OPERATIONS MANAGER
Name	:	SHERYL L MORRIS
Credential	:
Telephone Number	:	469-800-3524

Provider Enumeration Date	:	04/12/2007
Last Update Date	:	11/18/2016

Similar Medicare Providers

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Practice Location Address:

801 W MAIN STREET
GUN BARREL CITY, TX
75156-5312

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Practice Fax: 903-887-9441

1821093824 — DR. DOUGLAS W CURRAN MD
Practice Location Address:

801 W MAIN ST
GUN BARREL CITY, TX
75156-5312

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1245235266 — DR. CHARLES TED METTETAL M.D.
Practice Location Address:

801 W MAIN ST
GUN BARREL CITY, TX
75156-5312

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Practice Fax: 903-603-9441

1538161328 — MRS. DEBRA JEAN ROSSELL RN MSN CFNP
Practice Location Address:

801 W MAIN ST
GUN BARREL CITY, TX
75156-5312

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1144588872 — VICTORIA MARIE GROUNDS P.A.
Practice Location Address:

801 W MAIN ST
GUN BARREL CITY, TX
75156-5312

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1033506019 — MRS. ALICE RENEE SPLINTER MD
Practice Location Address:

801 W. MAIN ST.
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75156-5312

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Directions to “HEALTH TEXAS PROVIDER NETWORK ” Practice Location

Language	Start Address	Practice Location

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