# HEALTHTEXAS PROVIDER NETWORK

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1619518495
- **Authorized official:** MICHELLE J TELFORD (MANAGED CARE CONSULTANT)
- **Authorized official phone:** (469) 800-8648

## Contact information

- **Practice address:** 2020 W STATE HIGHWAY 114 STE 190, GRAPEVINE, TX 76051-8649
- **Practice address phone:** (972) 596-3242
- **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:** 10/03/2019
- **Last updated:** 12/29/2020