Organization
HEALTHTEXAS PROVIDER NETWORK
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE J TELFORD (MANAGED CARE CONSULTANT)
(469) 800-8648
Entity
Organization
Contact information
Practice address
1453 E BERT KOUNS INDUSTRIAL LOOP STE 212, SHREVEPORT, LA 71105-6810
(214) 820-6856
Mailing address
301 N WASHINGTON AVE, DALLAS, TX 75246-1754
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
Other
Enumeration date
09/06/2022
Last updated
09/06/2022
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