MEDICARE: METHODIST HOSPITALS OF DALLAS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QA1903X	Ambulatory Surgical Clinic/Center
2	282N00000X	General Acute Care Hospital	000142	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1275592131
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	METHODIST HOSPITALS OF DALLAS

Provider Business Mailing Address
First Line	:	PO BOX 911875
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75391-1875
Country	:	US
Telephone Number	:	214-947-7777
Fax Number	:

Provider Business Practice Location Address
First Line	:	3500 W WHEATLAND RD
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75237-3460
Country	:	US
Telephone Number	:	214-947-7777
Fax Number	:

Authorized Official
Title or Position	:	EXECUTIVE VP & CFO
Name	:	CRAIG ALLEN BJERKE
Credential	:
Telephone Number	:	214-947-4512

Provider Enumeration Date	:	03/20/2006
Last Update Date	:	06/12/2024

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Directions to “METHODIST HOSPITALS OF DALLAS ” Practice Location

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