Organization
HEALTHTEXAS PROVIDER NETWORK - WAXAHACHIE SURGICAL SPECIALIST, LLP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ELLEN ELIZABETH FOURTON (DIRECTOR)
(972) 860-8649
Entity
Organization
Contact information
Practice address
1505 W JEFFERSON ST, STE 165, WAXAHACHIE, TX 75165-2200
(972) 923-1457
(972) 923-1304
Mailing address
8060 N CENTRAL EXPY, STE 1650, DALLAS, TX 75206-1801
(972) 860-8653
(972) 860-8679
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
00863W
TX
Other
Enumeration date
06/20/2005
Last updated
02/23/2008
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