MEDICARE: HEALTHCARE EXPRESS, LLP

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	261QU0200X	Urgent Care Clinic/Center		TX
2	207Q00000X	Family Medicine Physician		TX

General Provider Information

NPI Number	:	1639453475
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEALTHCARE EXPRESS, LLP

Provider Business Mailing Address
First Line	:	3515 RICHMOND RD
Second Line	:
City	:	TEXARKANA
State	:	TX
Zip	:	75503-0711
Country	:	US
Telephone Number	:	903-791-9355
Fax Number	:	903-793-0496

Provider Business Practice Location Address
First Line	:	711 E END BLVD S
Second Line	:
City	:	MARSHALL
State	:	TX
Zip	:	75670-5615
Country	:	US
Telephone Number	:	903-938-4363
Fax Number	:	903-935-7394

Authorized Official
Title or Position	:	MANAGING PARTNER
Name	:	TIMOTHY L. REYNOLDS
Credential	:	M.D.
Telephone Number	:	903-791-9355

Provider Enumeration Date	:	09/28/2011
Last Update Date	:	12/13/2017

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Directions to “HEALTHCARE EXPRESS, LLP ” Practice Location

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