Healthcare Provider Details
I. General information
NPI: 1790232007
Provider Name (Legal Business Name): HEALTH SERVICES OF NORTH TEXAS, INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/02/2016
Last Update Date: 06/03/2024
Certification Date: 05/20/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5501 INDEPENDENCE PKWY STE 110
PLANO TX
75023-5472
US
IV. Provider business mailing address
4401 N INTERSTATE 35 UNIT 312
DENTON TX
76207-3318
US
V. Phone/Fax
- Phone: 940-381-1501
- Fax: 972-424-9117
- Phone: 940-381-1501
- Fax: 940-566-8059
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QF0400X |
| Taxonomy | Federally Qualified Health Center (FQHC) |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ANNA
CONTRERAS
Title or Position: CREDENTIALING MANAGER
Credential:
Phone: 940-435-9044