Provider Demographics
NPI:1952423782
Name:MY HEALTH MY RESOURCES OF TARRANT COUNTY
Entity Type:Organization
Organization Name:MY HEALTH MY RESOURCES OF TARRANT COUNTY
Other - Org Name:MHMR OF TARRANT COUNTY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ENROLLMENT COORDINATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ANGIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SWETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-569-4039
Mailing Address - Street 1:PO BOX 2603
Mailing Address - Street 2:HTN, CLIENT ACCOUNTING
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76113-2603
Mailing Address - Country:US
Mailing Address - Phone:817-569-4396
Mailing Address - Fax:817-569-4517
Practice Address - Street 1:3840 HULEN ST
Practice Address - Street 2:HTN, CLIENT ACCOUNTING
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76107-7277
Practice Address - Country:US
Practice Address - Phone:817-569-4396
Practice Address - Fax:817-569-4517
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:1376590422
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-04-04
Last Update Date:2022-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
2084P0800X
TX261QC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX081599501Medicaid
TX00AA27Medicare PIN