Organization Active NPI

Healthtexas Provider Network

Neurological Surgery Physician
Ft Worth, TX

National Provider Identifier

1821241605

Registry record updated Apr 20, 2010

On this page

Key facts
NPPES NPI Registry
National Provider Directory
NPI Registry JSON
Other providers in Ft Worth, TX
Sources for this page

Key facts

NPPES NPI Registry

Primary specialty: Neurological Surgery PhysicianTaxonomy code 207T00000X
Legal business name: HEALTHTEXAS PROVIDER NETWORK
Practice address: 900 W Magnolia Ave
Suite 201
Ft Worth, TX 76104-8517
Phone: (817) 921-6166
Fax: (817) 921-9594
NPI assigned: Oct 24, 2008
Organization subpart: No

NPPES NPI Registry

Updated by the provider on Apr 20, 2010

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

Authorized official

Name: Ellen E Fourton
Title: Director
Phone: (972) 860-8649

Specialties & licenses 7

Specialty (taxonomy)	Code	Primary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP	207Q00000X
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP	207R00000X
Neurological Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP	207T00000X	Primary
Orthopaedic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP	207X00000X
Otolaryngology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP	207Y00000X
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP	208000000X
Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP	208600000X

Addresses

Primary practice location

900 W Magnolia Ave
Suite 201
Ft Worth, TX 76104-8517

Mailing address

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

Other identifiers 2

Identifier	Type	State	Issuer
0077DJ	Other	TX	BCBS
200663701	Medicaid	TX

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1224806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1271721600000",
    "number": "1821241605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8080 N CENTRAL EXPY",
            "address_2": "SUITE 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": "900 W MAGNOLIA AVE",
            "address_2": "SUITE 201",
            "city": "FT WORTH",
            "state": "TX",
            "postal_code": "761048517",
            "telephone_number": "817-921-6166",
            "fax_number": "817-921-9594"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHTEXAS PROVIDER NETWORK",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-24",
        "last_updated": "2010-04-20",
        "status": "A",
        "authorized_official_last_name": "FOURTON",
        "authorized_official_first_name": "ELLEN",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "972-860-8649"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Neurological Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Otolaryngology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0077DJ",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200663701",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ft Worth, TX

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 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.