Organization
HEALTH TEXAS PROVIDER NETWORK
Active
Other names
PCA ELLINGTON
Organization subpart
No
Provider details
NPI number
Authorized official
SHERL L MORRIS MD (OPERATIONS MANAGER)
(469) 800-3524
Entity
Organization
Contact information
Practice address
4803 WESLEY ST, GREENVILLE, TX 75401
(903) 454-2246
(903) 450-1718
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
—
007EE
BCBS GROUP
TX
05
—
137940608
—
TX
01
—
P00134601
RAILROAD MEDICARE
TX
Enumeration date
04/13/2007
Last updated
11/23/2016
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