Healthcare Provider Details

I. General information

NPI: 1457492449
Provider Name (Legal Business Name): DFW CONSOLIDATED HEALTHCARE SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/11/2007
Last Update Date: 02/14/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 N KAUFMAN ST
SEAGOVILLE TX
75159-2813
US

IV. Provider business mailing address

1201 N KAUFMAN ST
SEAGOVILLE TX
75159-2813
US

V. Phone/Fax

Practice location:
  • Phone: 972-287-8300
  • Fax: 972-287-1882
Mailing address:
  • Phone: 972-287-8300
  • Fax: 972-287-1882

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number011892
License Number StateTX

VIII. Authorized Official

Name: PATRICIA MAZIE-KALU
Title or Position: ADMINISTRATOR
Credential:
Phone: 972-287-8300