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Organization
HEALTHTEXAS PROVIDER NETWORK
Active
Organization
HEALTHTEXAS PROVIDER NETWORK
Active
Other names
Family Medical Center at Terrell
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ELLEN ELIZABETH FOURTON (DIRECTOR)
(972) 860-8649
Entity
Organization
Contact information
Practice address
200 N VIRGINIA ST, TERRELL, TX 75160-2732
(972) 551-7500
(972) 524-7418
Mailing address
8080 N CENTRAL EXPY, STE 600, LB82, DALLAS, TX 75206-1838
(972) 860-8648
(972) 860-8679
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
00249N
TX
207R00000X
Internal Medicine Physician
00249N
TX
207RP1001X
Pulmonary Disease Physician
00249N
TX
208000000X
Pediatrics Physician
00249N
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00249N
BCBSTX
TX
05
—
0802258-01
—
TX
Enumeration date
06/20/2005
Last updated
04/20/2010
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