Healthcare Provider Details

I. General information

NPI: 1851385504
Provider Name (Legal Business Name): DALLAS COUNTY HOSPITAL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/08/2005
Last Update Date: 06/03/2024
Certification Date: 06/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

303 E OVERTON RD
DALLAS TX
75216-5946
US

IV. Provider business mailing address

5200 HARRY HINES BLVD
DALLAS TX
75235-7709
US

V. Phone/Fax

Practice location:
  • Phone: 469-419-1976
  • Fax: 469-419-6210
Mailing address:
  • Phone: 469-419-1976
  • Fax: 469-419-6210

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number4633300006
License Number StateTX

VIII. Authorized Official

Name: EDMUNDO CASTANEDA
Title or Position: EXEC VP & CHIEF OPERATING OFFICER
Credential:
Phone: 214-590-8006