Healthtexas-Med Provider

NPI #1992700512 in Dallas, Texas

Provider Information

NPI Number: 1992700512
Entity Type: Organization
Organization Name: Healthtexas-Med Provider
Primary Specialty: Internal Medicine
Enumeration Date: Jun 20, 2005
Last Updated: Apr 20, 2017

Practice Location

Address: 3417 GASTON AVE
Address 2: SUITE 1000
City: Dallas
State: Texas
ZIP Code: 75246-2016
Phone: (469) 800-9000

Authorized Official

Name: MRS. ELLEN ELIZABETH FOURTON
Title: DIRECTOR
Phone: (469) 800-8649

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Internal Medicine	207R00000X	Primary

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