Organization
HEALTHTEXAS PROVIDER NETWORK
Active
Other names
PCA GREENVILLE
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA HARDING (OPERATIONS MANAGER)
(469) 800-8500
Entity
Organization
Contact information
Practice address
4400 IH 30 W, SUITE 100, GREENVILLE, TX 75402-4620
(469) 800-3524
(469) 800-3564
Mailing address
8080 N CENTRAL EXPY STE 600, DALLAS, TX 75206-3794
(469) 800-8649
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00J629
BCBS GROUP
TX
05
—
091888002
—
TX
05
—
137940601
—
TX
05
—
137940607
—
TX
Enumeration date
06/03/2006
Last updated
06/07/2022
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