Healthcare Provider Details

I. General information

NPI: 1265368773
Provider Name (Legal Business Name): HEALTHTEXAS PROVIDER NETWORK
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/22/2026
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2535 IRA E WOODS AVE STE 100
GRAPEVINE TX
76051-3930
US

IV. Provider business mailing address

301 N WASHINGTON AVE STE 500
DALLAS TX
75246-1754
US

V. Phone/Fax

Practice location:
  • Phone: 817-481-2121
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: JENNIFER S REEVES
Title or Position: DIRECTOR
Credential:
Phone: 214-865-2753