Healthcare Provider Details

I. General information

NPI: 1487606596
Provider Name (Legal Business Name): COLUMBIA HOSPITAL AT MEDICAL CITY DALLAS SUBSIDIARY LP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/17/2006
Last Update Date: 11/07/2025
Certification Date: 11/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7777 FOREST LN
DALLAS TX
75230-2505
US

IV. Provider business mailing address

7777 FOREST LN
DALLAS TX
75230-2505
US

V. Phone/Fax

Practice location:
  • Phone: 972-566-7000
  • Fax: 972-566-6248
Mailing address:
  • Phone: 972-566-7000
  • Fax: 972-566-6248

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code273Y00000X
TaxonomyRehabilitation Hospital Unit
License Number
License Number State

VIII. Authorized Official

Name: SUSAN SHREEVE
Title or Position: CFO
Credential:
Phone: 972-566-6225