Organization
MEDHEALTH
Active
Other names
Methodist Medical Group
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER KENYON (CREDENTIALING MANAGER)
(214) 947-4523
Entity
Organization
Contact information
Practice address
4560 LAKE RIDGE PKWY STE 300, GRAND PRAIRIE, TX 75052-1706
(817) 453-3500
(817) 453-3520
Mailing address
4560 LAKE RIDGE PKWY STE 300, GRAND PRAIRIE, TX 75052-1706
(817) 453-3500
(817) 453-3520
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
10/25/2023
Last updated
10/25/2023
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