Healthcare Provider Details

I. General information

NPI: 1114273661
Provider Name (Legal Business Name): DALLAS FIRE RESCUE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/01/2012
Last Update Date: 08/01/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5000 DOLPHIN RD BLDG. A
DALLAS TX
75223-3112
US

IV. Provider business mailing address

5000 DOLPHIN RD BLDG. A
DALLAS TX
75223-3112
US

V. Phone/Fax

Practice location:
  • Phone: 214-670-3220
  • Fax:
Mailing address:
  • Phone: 214-670-3220
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License Number256388
License Number StateTX

VIII. Authorized Official

Name: MS. MYRTLE ALLISON GREEN
Title or Position: COMMUNICABLE DISEASE COORDINATOR
Credential: R.N.
Phone: 469-323-5775