Organization
HEALTHTEXAS PROVIDER NETWORK
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATE GONZALEZ (PROVIDER ENROLLMENT ANALYST)
(469) 800-8742
Entity
Organization
Contact information
Practice address
4400 I 30 W STE 300, GREENVILLE, TX 75402-4643
(469) 800-7200
(469) 800-7210
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
04/01/2025
Last updated
04/01/2025
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