Organization
HEALTH TEXAS PROVIDER NETWORK
Active
Other names
PCA-LEONARD
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM CANTRELL MD (MEDICAL DIRECTOR)
(903) 587-3331
Entity
Organization
Contact information
Practice address
700 N STATE HIGHWAY 78, LEONARD, TX 75452-0198
(903) 587-3331
(903) 587-2395
Mailing address
PO BOX 844128, DALLAS, TX 75284-4128
(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
01
—
006EE
BCBS GROUP
TX
Enumeration date
04/16/2007
Last updated
07/21/2022
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