NPIMap

Organization Active NPI

Healthtexas Provider Network--Dallas Diagnostic Association

  • Dermatology Physician
  • Garland, TX
National Provider Identifier
1255337275
Registry record updated Apr 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
00R87R Issued in TX
Legal business name
HEALTHTEXAS PROVIDER NETWORK--DALLAS DIAGNOSTIC ASSOCIATION
Practice address
601 Clara Barton Blvd
Ste 300
Garland, TX 75042-5755
Phone
(972) 494-6235
Fax
(972) 272-2073
NPI assigned
Jun 23, 2005
Last updated
Apr 22, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2010

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 7

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 00R87R TX Primary
Internal Medicine Physician 207R00000X 00R87R TX
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 00R87R TX
Gastroenterology Physician 207RG0100X 00R87R TX
Pulmonary Disease Physician 207RP1001X 00R87R TX
Rheumatology Physician 207RR0500X 00R87R TX
Neurology Physician 2084N0400X 00R87R TX

Addresses

Primary practice location

601 Clara Barton Blvd
Ste 300
Garland, TX 75042-5755

Mailing address

8080 N Central Expy
Ste 600, LB82
Dallas, TX 75206-1838
Phone (972) 860-8648

Other identifiers 2

IdentifierTypeStateIssuer
00R87ROtherTXBCBS
0849374-01MedicaidTX

National Provider Directory

National Provider Directory

Locations

7777 Forest Ln
Ste C340
Dallas, TX 75230
Phone (972) 566-7799

601 Clara Barton Blvd
Ste 140
Garland, TX 75042
Phone (972) 272-6561

4708 Alliance Blvd
Ste 410
Plano, TX 75093
Phone (972) 758-6000

Practitioners & affiliated clinicians

Practitioners 88

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 88

NPI Registry JSON

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

{
    "created_epoch": "1119484800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1271894400000",
    "number": "1255337275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8080 N CENTRAL EXPY",
            "address_2": "STE 600, LB82",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752061838",
            "telephone_number": "972-860-8648",
            "fax_number": "972-860-8679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 CLARA BARTON BLVD",
            "address_2": "STE 300",
            "city": "GARLAND",
            "state": "TX",
            "postal_code": "750425755",
            "telephone_number": "972-494-6235",
            "fax_number": "972-272-2073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHTEXAS PROVIDER NETWORK--DALLAS DIAGNOSTIC ASSOCIATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-23",
        "last_updated": "2010-04-22",
        "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": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "TX",
            "license": "00R87R",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "00R87R",
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "TX",
            "license": "00R87R",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "TX",
            "license": "00R87R",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "TX",
            "license": "00R87R",
            "primary": false
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "TX",
            "license": "00R87R",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "TX",
            "license": "00R87R",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "00R87R",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0849374-01",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Garland, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2010; 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.