Organization
HEALTHTEXAS PROVIDER NETWORK
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE J TELFORD (MANAGED CARE CONSULTANT)
(469) 800-8648
Entity
Organization
Contact information
Practice address
2020 W STATE HIGHWAY 114 STE 190, GRAPEVINE, TX 76051-8649
(972) 596-3242
Mailing address
301 N WASHINGTON AVE, DALLAS, TX 75246-1754
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
10/03/2019
Last updated
12/29/2020
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