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NPI Code Detail

MEDICARE: TEXAS HEALTH

MEDICARE: TEXAS HEALTH
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
1302R00000XHealth Maintenance Organization63195TX

General Provider Information

NPI Number : 1952542813
Entity Type Code : Organization
Provider Name (Legal Business Name) : TEXAS HEALTH
Provider Business Mailing Address
First Line : 5445 LA SIERRA DR
Second Line : SUITE 204
City : DALLAS
State : TX
Zip : 75231-4139
Country : US
Telephone Number : 214-692-6666
Fax Number : 214-692-6670
Provider Business Practice Location Address
First Line : 185 EASTGATE PLZ
Second Line :
City : WACO
State : TX
Zip : 76705-2868
Country : US
Telephone Number : 254-412-2667
Fax Number : 254-799-5768
Authorized Official
Title or Position : LPC, CLINICAL SUPERVISOR
Name : PHIL BOHART
Credential : MS,CRC,LPC#15980
Telephone Number : 214-692-6666
Provider Enumeration Date : 03/23/2009
Last Update Date : 03/23/2009

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Directions to “TEXAS HEALTH ” Practice Location

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