Provider Demographics
NPI:1679869218
Name:RESOLUTE HEALTH PHYSICIANS NETWORK INC
Entity type:Organization
Organization Name:RESOLUTE HEALTH PHYSICIANS NETWORK INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:TESS
Authorized Official - Middle Name:
Authorized Official - Last Name:COODY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:830-387-5450
Mailing Address - Street 1:301 MAIN PLZ
Mailing Address - Street 2:STE 195
Mailing Address - City:NEW BRAUNFELS
Mailing Address - State:TX
Mailing Address - Zip Code:78130-5136
Mailing Address - Country:US
Mailing Address - Phone:866-819-2816
Mailing Address - Fax:830-632-6568
Practice Address - Street 1:66 GRUENE PARK DR
Practice Address - Street 2:SUITE 210
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78130-2460
Practice Address - Country:US
Practice Address - Phone:615-665-6000
Practice Address - Fax:615-665-6197
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-22
Last Update Date:2016-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX295163401Medicaid
TXTXB138268Medicare PIN