# HEALTHTEXAS PROVIDER NETWORK-WAXAHACHIE SURGICAL SPECIALISTS, L.L.P.

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

## Provider details

- **NPI number:** 1154457976
- **Authorized official:** MRS. ELLEN E FOURTON (DIRECTOR)
- **Authorized official phone:** (972) 860-8649

## Contact information

- **Practice address:** 1404 W JEFFERSON ST, WAXAHACHIE, TX 75165-2232
- **Practice address phone:** (972) 923-9999
- **Practice address fax:** (972) 923-9488
- **Mailing address:** 8080 N CENTRAL EXPY, SUITE 1650, DALLAS, TX 75206-1838
- **Mailing address phone:** (972) 860-8648
- **Mailing address fax:** (972) 860-8679

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | Yes |
| 332BC3200X | Customized Equipment (DME) | — | NULL | — |

## Other

- **Enumeration date:** 02/26/2007
- **Last updated:** 02/23/2008