Healthcare Provider Details

I. General information

NPI: 1437175494
Provider Name (Legal Business Name): DALLAS METROCARE SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/14/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 RIVER BEND DR APT 71
LANCASTER TX
75146-3707
US

IV. Provider business mailing address

1100 RIVER BEND DR APT 71
LANCASTER TX
75146-3707
US

V. Phone/Fax

Practice location:
  • Phone: 214-381-7070
  • Fax: 214-381-7071
Mailing address:
  • Phone: 214-381-7070
  • Fax: 214-381-7071

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code322D00000X
TaxonomyEmotionally Disturbed Childrens' Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: MS. COURTNEY SHAVON BECK
Title or Position: QMHP
Credential: B.S.
Phone: 214-381-7070