Provider Demographics
NPI:1063977908
Name:HEALTHTEXAS PROVIDER NETWORK
Entity type:Organization
Organization Name:HEALTHTEXAS PROVIDER NETWORK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGED CARE CONSULTANT
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:J
Authorized Official - Last Name:TELFORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-800-8648
Mailing Address - Street 1:8080 N CENTRAL EXPY STE 600
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75206-3794
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3800 GAYLORD PKWY STE 810
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-9420
Practice Address - Country:US
Practice Address - Phone:469-800-7540
Practice Address - Fax:469-800-8545
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-05
Last Update Date:2019-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty