Healthcare Provider Details

I. General information

NPI: 1174240857
Provider Name (Legal Business Name): NEXUS CHILDREN'S HOSPITAL- DALLAS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/24/2022
Last Update Date: 05/14/2024
Certification Date: 05/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9525 GREENVILLE AVE
DALLAS TX
75243-4116
US

IV. Provider business mailing address

1 RIVERWAY STE 700
HOUSTON TX
77056-1988
US

V. Phone/Fax

Practice location:
  • Phone: 713-355-6111
  • Fax:
Mailing address:
  • Phone: 713-355-6111
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code281PC2000X
TaxonomyChildren's Chronic Disease Hospital
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code282NC2000X
TaxonomyChildren's Hospital
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code283XC2000X
TaxonomyChildren's Rehabilitation Hospital
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code284300000X
TaxonomySpecial Hospital
License Number
License Number State

VIII. Authorized Official

Name: ERIN CASSIDY
Title or Position: PRESIDENT
Credential:
Phone: 713-589-4136