| Healthtexas Provider Network | |
|
1110 Parker Sq Flower Mound TX 75028-7432 | |
| (972) 724-1707 | |
| (972) 724-1407 |
| Full Name | Healthtexas Provider Network |
|---|---|
| Speciality | Family Medicine |
| Location | 1110 Parker Sq, Flower Mound, Texas |
| Authorized Official Name and Position | Ellen Elizabeth 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 Ste 600, Lb82 Dallas TX 75206-1838 Ph: (972) 860-8648 | Healthtexas Provider Network 1110 Parker Sq Flower Mound TX 75028-7432 Ph: (972) 724-1707 |
| NPI Number | 1427054402 |
|---|---|
| Provider Enumeration Date | 06/23/2005 |
| Last Update Date | 04/22/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427054402 | NPI | - | NPPES |
| 0855389-01 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 00U07B (Texas) | Primary |
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