# HEALTHTEXAS PROVIDER NETWORK

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

## Provider details

- **NPI number:** 1689031692
- **Authorized official:** ELLEN FOURTON (VICE PRESIDENT)
- **Authorized official phone:** (469) 800-8649

## Contact information

- **Practice address:** 411 N WASHINGTON AVE, SUITE 411, DALLAS, TX 75246-1713
- **Practice address phone:** (214) 818-7066
- **Practice address fax:** (214) 820-9869
- **Mailing address:** 411 N WASHINGTON AVE, SUITE 411, DALLAS, TX 75246-1713
- **Mailing address phone:** (214) 818-7066
- **Mailing address fax:** (214) 820-9869

## Taxonomy

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

## Other

- **Enumeration date:** 01/21/2016
- **Last updated:** 01/21/2016