| Organization Name: | HEALTHTEXAS PROVIDER NETWORK-WAXAHACHIE SURGICAL SPECIALISTS, L.L.P. |
| NPI Number: | 1154457976 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ELLEN E FOURTON (DIRECTOR) |
| Mailing Address: | 1404 W Jefferson St Waxahachie |
| State: | TX US |
| Postal Code: | 751652232 |
| Phone Number: | 9729239999 |
| Fax Number: | 9729239488 |
| NPI Enumeration Date: | 02/26/2007 |
| NPI Last Update Date: | 02/23/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 332BC3200X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
| Taxonomy Specialization: | Customized Equipment |
| Taxonomy Definition: | |