# HEALTHTEXAS PROVIDER NETWORK

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1053953315
- **Authorized official:** MICHELLE J TELFORD (MANAGED CARE CONSULTANT)
- **Authorized official phone:** (469) 800-8648

## Contact information

- **Practice address:** 200 N VIRGINIA ST, TERRELL, TX 75160-2732
- **Practice address phone:** (214) 820-8700
- **Mailing address:** 301 N WASHINGTON AVE, DALLAS, TX 75246-1754

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | Yes |

## Other

- **Enumeration date:** 10/08/2019
- **Last updated:** 12/31/2020