Organization
HEALTH TEXAS PROVIDER NETWORK, CRNA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ELLEN ELIZABETH FOURTON (DIRECTOR)
(972) 860-8649
Entity
Organization
Contact information
Practice address
3500 GASTON AVE, DALLAS, TX 75246-2096
(214) 820-2170
(214) 820-7977
Mailing address
8080 N CENTRAL EXPY, STE 1650, DALLAS, TX 75206-3789
(972) 860-8653
(972) 860-8679
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
00926V
TX
Other
Enumeration date
06/20/2005
Last updated
08/22/2020
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