MEDICARE: PHYSICIANS AND ALLIED HEALTH PROFESSIONALS GROUP, PA

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	207RC0000X	Cardiovascular Disease Physician
2	111N00000X	Chiropractor
3	207R00000X	Internal Medicine Physician
4	208D00000X	General Practice Physician
5	208600000X	Surgery Physician
6	207V00000X	Obstetrics & Gynecology Physician
7	207RH0003X	Hematology & Oncology Physician
8	207W00000X	Ophthalmology Physician
9	207X00000X	Orthopaedic Surgery Physician
10	207LP2900X	Pain Medicine (Anesthesiology) Physician
11	208000000X	Pediatrics Physician
12	208100000X	Physical Medicine & Rehabilitation Physician
13	363AM0700X	Medical Physician Assistant
14	363L00000X	Nurse Practitioner
15	207Q00000X	Family Medicine Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0046AZ	OTHER	TX	BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
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	:	1528011814
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PHYSICIANS AND ALLIED HEALTH PROFESSIONALS GROUP, PA

Provider Business Mailing Address
First Line	:	12700 PARK CENTRAL DR
Second Line	:	STE 900
City	:	DALLAS
State	:	TX
Zip	:	75251-1500
Country	:	US
Telephone Number	:	214-860-6053
Fax Number	:	469-854-0738

Provider Business Practice Location Address
First Line	:	12700 PARK CENTRAL DR
Second Line	:	STE 900
City	:	DALLAS
State	:	TX
Zip	:	75251-1500
Country	:	US
Telephone Number	:	214-860-6053
Fax Number	:	469-854-0738

Authorized Official
Title or Position	:	PRESIDENT
Name	:	CLAY M. HEIGHTEN
Credential	:	M.D.
Telephone Number	:	972-739-3001

Provider Enumeration Date	:	05/18/2006
Last Update Date	:	01/13/2012

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Directions to “PHYSICIANS AND ALLIED HEALTH PROFESSIONALS GROUP, PA ” Practice Location

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