MEDICARE: LIFE POINT HEALTHCARE SERVICES OF TEXAS

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	101YA0400X	Addiction (Substance Use Disorder) Counselor
2	251S00000X	Community/Behavioral Health Agency
3	3245S0500X	Children's Substance Abuse Rehabilitation Facility
4	261QR0405X	Substance Use Disorder Rehabilitation Clinic/Center

General Provider Information

NPI Number	:	1932998382
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LIFE POINT HEALTHCARE SERVICES OF TEXAS

Provider Business Mailing Address
First Line	:	PO BOX 966
Second Line	:
City	:	DURHAM
State	:	NC
Zip	:	27702-0966
Country	:	US
Telephone Number	:	919-706-9474
Fax Number	:	214-550-3864

Provider Business Practice Location Address
First Line	:	4101 MCEWEN RD STE 140
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75244-5478
Country	:	US
Telephone Number	:	214-550-7150
Fax Number	:	214-550-3864

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. DEVANTE MULLEN
Credential	:
Telephone Number	:	214-550-7150

Provider Enumeration Date	:	05/02/2025
Last Update Date	:	03/20/2026

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Directions to “LIFE POINT HEALTHCARE SERVICES OF TEXAS ” Practice Location

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