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NPI Code Detail

MEDICARE: HEALTHTEXAS PROVIDER NETWORK

MEDICARE: HEALTHTEXAS PROVIDER NETWORK
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language Pathologist

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10077DJOTHERTXBCBS

General Provider Information

NPI Number : 1619476439
Entity Type Code : Organization
Provider Name (Legal Business Name) : HEALTHTEXAS PROVIDER NETWORK
Provider Business Mailing Address
First Line : 8080 N CENTRAL EXPY STE 900
Second Line :
City : DALLAS
State : TX
Zip : 75206-1800
Country : US
Telephone Number : 469-800-8648
Fax Number :
Provider Business Practice Location Address
First Line : 3900 JUNIUS ST STE 230
Second Line :
City : DALLAS
State : TX
Zip : 75246-1615
Country : US
Telephone Number : 469-800-7700
Fax Number :
Authorized Official
Title or Position : DIRECTOR
Name : JENNIFER S. REEVES
Credential :
Telephone Number : 469-800-8332
Provider Enumeration Date : 02/07/2018
Last Update Date : 02/07/2018

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Directions to “HEALTHTEXAS PROVIDER NETWORK ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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