Organization
HEALTHTEXAS PROVIDER NETWORK-ORTHOPEDIC SERVICES, LLP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ELLEN ELIZABETH FOURTON (DIRECTOR)
(972) 860-8649
Entity
Organization
Contact information
Practice address
3600 GASTON AVE, STE 1101, DALLAS, TX 75246-1811
(214) 820-8350
(214) 820-8355
Mailing address
8080 N CENTRAL EXPY, LB 82, STE 1650, DALLAS, TX 75206
(972) 860-8648
(972) 860-8679
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
00303W
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0032KV
BCBS
TX
Enumeration date
06/23/2005
Last updated
03/12/2008
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