Organization
HEALTHTEXAS PROVIDER NETWORK-PHYSIATRIC MEDICINE ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ELLEN ELIZABETH FOURTON (DIRECTOR)
(972) 860-8649
Entity
Organization
Contact information
Practice address
3504 SWISS AVE, DALLAS, TX 75204-6224
(214) 820-9849
(214) 820-9787
Mailing address
8080 N CENTRAL EXPRESSWAY, LB 82, STE 1650, DALLAS, TX 75206
(972) 860-8653
(972) 860-8679
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
00T89Z
TX
Other
Enumeration date
06/20/2005
Last updated
08/22/2020
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