Healthcare Provider Details

I. General information

NPI: 1548376379
Provider Name (Legal Business Name): VA NORTH TEXAS HEALTH CARE SYSTEM
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/22/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4500 S. LANCASTER RD DALLAS VA MEDICAL CENTER, APMS(112A)
DALLAS TX
75216
US

IV. Provider business mailing address

4500 S. LANCASTER RD DALLAS VA MEDICAL CENTER, APMS(112A)
DALLAS TX
75216
US

V. Phone/Fax

Practice location:
  • Phone: 214-857-1818
  • Fax: 214-857-1867
Mailing address:
  • Phone: 214-857-1818
  • Fax: 214-857-1867

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code284300000X
TaxonomySpecial Hospital
License Number156738
License Number StateMA

VIII. Authorized Official

Name: DR. SYED ADIL AHMED
Title or Position: STAFF ANESTHESIOLOGIST
Credential: M.D.
Phone: 214-857-1818