NPIMap

Organization Active NPI

Healthtexas Provider Network

  • Family Medicine Physician
  • Plano, TX
National Provider Identifier
1124809512
Registry record updated Oct 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
HEALTHTEXAS PROVIDER NETWORK
Practice address
5717 Legacy Dr Ste 180
Plano, TX 75024-4255
Phone
(888) 663-6331
NPI assigned
Oct 11, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Michelle J Telford
Title
Managed Care Consultant
Phone
(214) 865-2774

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

5717 Legacy Dr Ste 180
Plano, TX 75024-4255

Mailing address

301 N Washington Ave
Dallas, TX 75246-1754

Other names 1

  • One Medical with Baylor Scott & White Health Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040727001187 TX Part B Supplier - Clinic/Group Practice 1355254210 Receives reassigned benefits from 3,506 practitioners
12 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment

Other NPIs on the same Medicare enrollment 12

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D2284841One Medical5717 Legacy Dr Ste 180 - Commercial, Plano, TX 75024Provider-performed microscopyJun 28, 2027

National Provider Directory

National Provider Directory

Locations

1400 8th Ave
#C770
Fort Worth, TX 76104
Phone (817) 922-1770

1101 6th Ave
Ste 110
Fort Worth, TX 76104
Phone (817) 912-8040

Practitioners & affiliated clinicians

Practitioners 82

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 82

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1696982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696982400000",
    "number": "1124809512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 N WASHINGTON AVE",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752461754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5717 LEGACY DR STE 180",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750244255",
            "telephone_number": "888-663-6331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHTEXAS PROVIDER NETWORK",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-11",
        "last_updated": "2023-10-11",
        "certification_date": "2023-10-11",
        "status": "A",
        "authorized_official_last_name": "TELFORD",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "MANAGED CARE CONSULTANT",
        "authorized_official_telephone_number": "214-865-2774"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "One Medical with Baylor Scott & White Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Plano, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.