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General NPI Number Information
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NPI Number | 1295628709
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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 | 06/02/2025
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Last Update Date | 06/25/2025
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Provider Practice Location Address
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Address Line | 1400 8TH AVE # C770
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City | FORT WORTH
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State | TX
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Zip | 76104-4110
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Country | US
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Telephone | 817-922-1770
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Fax |
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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 |
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Authorized Official
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Title or Position | DIRECTOR
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Name | 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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number |
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License Number State |
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