Healthtexas Provider Network - Physiatric Medicine Associates

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

0016AH Issued in TX

Legal business name

HEALTHTEXAS PROVIDER NETWORK - PHYSIATRIC MEDICINE ASSOCIATES

Practice address

507 N Highway 77
Ste 700
Waxahachie, TX 75165-1889

Phone

(972) 923-2738

Fax

(972) 935-9230

NPI assigned

Jun 20, 2005

Organization subpart

No

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

Authorized official

Name

Mrs. Ellen Elizabeth Fourton

Title

Director

Phone

(972) 860-8649

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1119225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204848000000",
    "number": "1205831823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8080 N CENTRAL EXPY, LB 82",
            "address_2": "STE 1650",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752063789",
            "telephone_number": "972-860-8653",
            "fax_number": "972-860-8679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "507 N HIGHWAY 77",
            "address_2": "STE 700",
            "city": "WAXAHACHIE",
            "state": "TX",
            "postal_code": "751651889",
            "telephone_number": "972-923-2738",
            "fax_number": "972-935-9230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHTEXAS PROVIDER NETWORK - PHYSIATRIC MEDICINE ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-20",
        "last_updated": "2008-03-07",
        "status": "A",
        "authorized_official_last_name": "FOURTON",
        "authorized_official_first_name": "ELLEN",
        "authorized_official_middle_name": "ELIZABETH",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "972-860-8649",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "TX",
            "license": "0016AH",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "00T89Z",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Physical Medicine & Rehabilitation Physician in Waxahachie, TX
• Providers in Waxahachie, TX by specialty
• Physical Medicine & Rehabilitation Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.