Organization
HEALTHTEXAS PROVIDER NETWORK-NEUROSURGICAL ASSOCIATES, 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 1158-WADLEY, DALLAS, TX 75246
(214) 820-8585
(214) 820-8590
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
207T00000X
Neurological Surgery Physician
Primary
00554X
TX
2085R0001X
Radiation Oncology Physician
00554X
TX
Other
Enumeration date
06/20/2005
Last updated
11/27/2007
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