# HEALTHTEXAS PROVIDER NETWORK - PHYSIATRIC MEDICINE ASSOCIATES

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

## Provider details

- **NPI number:** 1205831823
- **Authorized official:** MRS. ELLEN ELIZABETH FOURTON (DIRECTOR)
- **Authorized official phone:** (972) 860-8649

## Contact information

- **Practice address:** 507 N HIGHWAY 77, STE 700, WAXAHACHIE, TX 75165-1889
- **Practice address phone:** (972) 923-2738
- **Practice address fax:** (972) 935-9230
- **Mailing address:** 8080 N CENTRAL EXPY, LB 82, STE 1650, DALLAS, TX 75206-3789
- **Mailing address phone:** (972) 860-8653
- **Mailing address fax:** (972) 860-8679

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | 0016AH | TX | Yes |

## Other

- **Enumeration date:** 06/20/2005
- **Last updated:** 03/07/2008