Organization
HEALTHTEXAS PROVIDER NETWORK
Active
Other names
PCA ROYSE CITY
Organization subpart
No
Provider details
NPI number
Authorized official
TONIE HALL (OPERATIONS MANAGER)
(469) 800-3670
Entity
Organization
Contact information
Practice address
6257 FM 2642 BLVD, SUITE 100, ROYSE CITY, TX 75189-3223
(469) 800-3670
(469) 800-3680
Mailing address
PO BOX 844128, DALLAS, TX 75284-2148
(469) 800-3524
(469) 800-3564
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
091888002
—
TX
05
—
137940601
—
TX
01
—
8G4495
BCBS PROVIDER #
TX
Enumeration date
04/23/2007
Last updated
05/08/2024
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