Provider Demographics
NPI:1174652184
Name:HEALTH TEXAS PROVIDER NETWORK
Entity Type:Organization
Organization Name:HEALTH TEXAS PROVIDER NETWORK
Other - Org Name:PULMONARY & CRITICAL CARE ASSOCIATES OF GARLAND
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELLEN
Authorized Official - Middle Name:E
Authorized Official - Last Name:FOURTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-860-8649
Mailing Address - Street 1:8080 N CENTRAL EXPY
Mailing Address - Street 2:SUITE 1650
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75206-1838
Mailing Address - Country:US
Mailing Address - Phone:972-860-8648
Mailing Address - Fax:972-860-8679
Practice Address - Street 1:700 WALTER REED BLVD
Practice Address - Street 2:SUITE 203
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75042-3701
Practice Address - Country:US
Practice Address - Phone:972-494-1446
Practice Address - Fax:972-276-5476
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-05
Last Update Date:2008-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment