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General NPI Number Information
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NPI Number | 1003811639
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Entity Type | Organization
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Legal Business Name | HEALTHTEXAS PROVIDER NETWORK
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Dates
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Enumeration Date | 06/20/2005
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Last Update Date | 11/06/2025
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Provider Practice Location Address
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Address Line | 1820 PRESTON PARK BLVD STE 1450
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City | PLANO
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State | TX
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Zip | 75093-3691
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Country | US
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Telephone | 469-800-4540
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Fax | 469-800-4541
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Provider Business Mailing Address
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Address Line | 301 N WASHINGTON AVE
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City | DALLAS
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State | TX
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Zip | 75246-1754
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Country | US
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Telephone | 469-800-8742
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Fax | 469-800-8679
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Authorized Official
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Title or Position | DIRECTOR
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Name | MRS. JENNIFER S. REEVES
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Credential |
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Telephone | 214-865-2753
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 00348T
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 00348T
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 00348T
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License Number State | TX
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