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
1	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1831730613
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEALTHTEXAS PROVIDER NETWORK

Provider Business Mailing Address
First Line	:	8080 N CENTRAL EXPY STE 600
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75206-3794
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2001 N MACARTHUR BLVD STE 425
Second Line	:
City	:	IRVING
State	:	TX
Zip	:	75061-2299
Country	:	US
Telephone Number	:	469-800-1330
Fax Number	:

Authorized Official
Title or Position	:	MANAGED CARE CONSULTANT
Name	:	MICHELLE J TELFORD
Credential	:
Telephone Number	:	469-800-8648

Provider Enumeration Date	:	10/03/2019
Last Update Date	:	10/03/2019

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Directions to “HEALTHTEXAS PROVIDER NETWORK ” Practice Location

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