Healthcare Provider Details

I. General information

NPI: 1750507646
Provider Name (Legal Business Name): SICKLE CELL DISEASE ASSOCIATION OF DALLAS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/18/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

320 SOUTH R L THORNTON FREEWAY SUITE 110
DALLAS TX
75203-1804
US

IV. Provider business mailing address

320 SR L THORNTON FWY SUITE 110
DALLAS TX
75203-1804
US

V. Phone/Fax

Practice location:
  • Phone: 214-942-1262
  • Fax: 214-948-9517
Mailing address:
  • Phone: 214-942-1262
  • Fax: 214-948-9517

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number27150
License Number StateTX

VIII. Authorized Official

Name: MS. MARY GRIFFIN
Title or Position: PRESIDENT CEO
Credential: LMSW
Phone: 214-942-1262