Healthcare Provider Details

I. General information

NPI: 1154544799
Provider Name (Legal Business Name): DALLAS METROCARE SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/11/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1340 RIVER BEND DR
DALLAS TX
75247-4914
US

IV. Provider business mailing address

3220 N GALLOWAY AVE APT 1114
MESQUITE TX
75150-4777
US

V. Phone/Fax

Practice location:
  • Phone: 214-743-6188
  • Fax:
Mailing address:
  • Phone: 972-270-3540
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number StateTX

VIII. Authorized Official

Name: MR. WILLIAM E. TAYLOR
Title or Position: QMHP
Credential: BA
Phone: 214-434-6525