MEDICARE: PATIENT CENTERED HEALTH GROUP

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	101Y00000X	Counselor
2	251B00000X	Case Management Agency
3	251E00000X	Home Health Agency
4	251F00000X	Home Infusion Agency
5	251J00000X	Nursing Care Agency
6	253Z00000X	In Home Supportive Care Agency
7	261Q00000X	Clinic/Center
8	261QH0100X	Health Service Clinic/Center
9	261QI0500X	Infusion Therapy Clinic/Center
10	261QM0850X	Adult Mental Health Clinic/Center
11	261QP2300X	Primary Care Clinic/Center
12	261QM1300X	Multi-Specialty Clinic/Center

General Provider Information

NPI Number	:	1891346870
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PATIENT CENTERED HEALTH GROUP

Provider Business Mailing Address
First Line	:	9710 COUNTY ROAD 2426
Second Line	:
City	:	TERRELL
State	:	TX
Zip	:	75160-8825
Country	:	US
Telephone Number	:	972-877-7767
Fax Number	:	877-779-1769

Provider Business Practice Location Address
First Line	:	9710 COUNTY ROAD 2426
Second Line	:
City	:	TERRELL
State	:	TX
Zip	:	75160-8825
Country	:	US
Telephone Number	:	972-877-7767
Fax Number	:

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	DR. DIANA WOOLVERTON
Credential	:	CHIROPRACTOR
Telephone Number	:	972-877-7767

Provider Enumeration Date	:	09/22/2019
Last Update Date	:	09/22/2019

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Directions to “PATIENT CENTERED HEALTH GROUP ” Practice Location

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