Provider Demographics
NPI:1558762690
Name:MEDHEALTH
Entity Type:Organization
Organization Name:MEDHEALTH
Other - Org Name:METHODIST MEDICAL GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:A
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:214-884-4744
Mailing Address - Street 1:3400 W. WHEATLAND ROAD
Mailing Address - Street 2:BLDG. 111, SUITE 360
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75237
Mailing Address - Country:US
Mailing Address - Phone:214-884-4700
Mailing Address - Fax:214-884-4761
Practice Address - Street 1:4560 LAKE RIDGE PKWY STE 110
Practice Address - Street 2:
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75052-1707
Practice Address - Country:US
Practice Address - Phone:972-522-7778
Practice Address - Fax:972-522-7779
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-09
Last Update Date:2020-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care