# HEALTHTEXAS PROVIDER NETWORK

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

## Provider details

- **NPI number:** 1538710199
- **Authorized official:** MICHELLE J TELFORD (MANAGED CARE CONSULTANT)
- **Authorized official phone:** (469) 800-8648

## Contact information

- **Practice address:** 4501 SWISS AVE, DALLAS, TX 75204-7119
- **Practice address phone:** (214) 820-8700
- **Mailing address:** 8080 N CENTRAL EXPY STE 600, DALLAS, TX 75206-3794
- **Mailing address phone:** (469) 800-8648

## Taxonomy

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

## Other

- **Enumeration date:** 09/25/2019
- **Last updated:** 09/25/2019