Provider Demographics
NPI:1124538442
Name:HEALTH SERVICES OF NORTH TEXAS, INC
Entity Type:Organization
Organization Name:HEALTH SERVICES OF NORTH TEXAS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SENIOR PRACTICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:NAVARRO
Authorized Official - Last Name:CONTRERAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:940-435-9044
Mailing Address - Street 1:4401 N INTERSTATE 35 UNIT 312
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76207-3318
Mailing Address - Country:US
Mailing Address - Phone:940-381-1501
Mailing Address - Fax:940-566-8059
Practice Address - Street 1:4304 MESA DRIVE
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76207
Practice Address - Country:US
Practice Address - Phone:940-381-1501
Practice Address - Fax:940-591-7830
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-02
Last Update Date:2024-03-08
Deactivation Date:2024-03-01
Deactivation Code:
Reactivation Date:2024-03-08
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX3774838201Medicaid