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General NPI Number Information
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NPI Number | 1174747950
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Entity Type | Organization
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Legal Business Name | HEALTH TEXAS PROVIDER NETWORK
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Dates
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Enumeration Date | 04/12/2007
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Last Update Date | 11/18/2016
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Provider Practice Location Address
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Address Line | 801 W MAIN ST
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City | GUN BARREL CITY
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State | TX
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Zip | 75156-5312
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Country | US
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Telephone | 903-887-6252
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 844128
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City | DALLAS
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State | TX
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Zip | 75284-4128
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Country | US
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Telephone | 469-800-3524
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Fax | 469-800-3564
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Authorized Official
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Title or Position | OPERATIONS MANAGER
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Name | SHERYL L MORRIS
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Credential |
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Telephone | 469-800-3524
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number |
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License Number State |
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