MEDICARE: HEALTHTEXAS PROVIDER NETWORK-TRANSPLANT SERVICES LLP

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
1	208600000X	Surgery Physician	00732U	TX
2	204F00000X	Transplant Surgery Physician	00732U	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	0078JQ	OTHER	TX	BCBSTX

General Provider Information

NPI Number	:	1790782654
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEALTHTEXAS PROVIDER NETWORK-TRANSPLANT SERVICES LLP

Provider Business Mailing Address
First Line	:	8080 N CENTRAL EXPY
Second Line	:	SUITE 600, LB82
City	:	DALLAS
State	:	TX
Zip	:	75206-1838
Country	:	US
Telephone Number	:	972-860-8648
Fax Number	:	972-860-8679

Provider Business Practice Location Address
First Line	:	1400 8TH AVE
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76104-4110
Country	:	US
Telephone Number	:	817-922-4650
Fax Number	:	817-922-4655

Authorized Official
Title or Position	:	DIRECTOR
Name	:	MRS. ELLEN ELIZABETH FOURTON
Credential	:
Telephone Number	:	972-860-8649

Provider Enumeration Date	:	07/06/2005
Last Update Date	:	05/05/2010

Similar Medicare Providers

1164353975 — SYMMETRY ANESTHESIA CLINICIANS PLLC
Practice Location Address:

1400 8TH AVE
FORT WORTH, TX
76104-4110

Practice Phone: 817-922-1535
Practice Fax:

1225968654 — HEALTHTEXAS PROVIDER NETWORK
Practice Location Address:

1400 8TH AVE STE A1131
FORT WORTH, TX
76104-4110

Practice Phone: 817-912-9250
Practice Fax:

1376414722 — ARIEL RICHARDSON
Practice Location Address:

1400 8TH AVE
FORT WORTH, TX
76104-4110

Practice Phone: 512-808-0237
Practice Fax:

1710815394 — SHAYLA ANNE SEEGMILLER RN, IBCLC
Practice Location Address:

1400 8TH AVE
FORT WORTH, TX
76104-4110

Practice Phone: 512-808-0237
Practice Fax:

1902735038 — BAYLOR ALL SAINTS MEDICAL CENTER
Practice Location Address:

1400 8TH AVE
FORT WORTH, TX
76104-4110

Practice Phone: 817-922-1957
Practice Fax:

1831192863 — MONCRIEF CANCER CENTER
Practice Location Address:

1450 8TH AVE
FORT WORTH, TX
76104-4110

Practice Phone: 817-923-7393
Practice Fax: 817-927-4532

Directions to “HEALTHTEXAS PROVIDER NETWORK-TRANSPLANT SERVICES LLP ” 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.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.