Provider Demographics
NPI:1790466027
Name:TEXAS HEALTH ARMORY
Entity Type:Organization
Organization Name:TEXAS HEALTH ARMORY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:HOLLIS
Authorized Official - Last Name:GODWIN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:469-231-3458
Mailing Address - Street 1:2351 CHRISTINE LN
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:TX
Mailing Address - Zip Code:76065-2318
Mailing Address - Country:US
Mailing Address - Phone:469-231-3458
Mailing Address - Fax:
Practice Address - Street 1:6205 LA VISTA DR
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75214-4312
Practice Address - Country:US
Practice Address - Phone:214-434-1853
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-28
Last Update Date:2023-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes202D00000XAllopathic & Osteopathic PhysiciansIntegrative MedicineGroup - Multi-Specialty