| Healthtexas Provider Network | |
|
900 W Magnolia Ave Suite 201 Ft Worth TX 76104-8517 | |
| (817) 921-6166 | |
| (817) 921-9594 |
| Full Name | Healthtexas Provider Network |
|---|---|
| Speciality | Neurological Surgery |
| Location | 900 W Magnolia Ave, Ft Worth, Texas |
| Authorized Official Name and Position | Ellen E Fourton (DIRECTOR) |
| Authorized Official Contact | 9728608649 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Healthtexas Provider Network 8080 N Central Expy Suite 600, Lb82 Dallas TX 75206-1838 Ph: (972) 860-8648 | Healthtexas Provider Network 900 W Magnolia Ave Suite 201 Ft Worth TX 76104-8517 Ph: (817) 921-6166 |
| NPI Number | 1821241605 |
|---|---|
| Provider Enumeration Date | 10/24/2008 |
| Last Update Date | 04/20/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821241605 | NPI | - | NPPES |
| 0077DJ | Other | TX | BCBS |
| 200663701 | Medicaid | TX |
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