Healthcare Provider Details

I. General information

NPI: 1093765026
Provider Name (Legal Business Name): DALLAS COUNTY HOSPITAL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2006
Last Update Date: 12/22/2024
Certification Date: 12/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 SARA SWAMY DRIVE
SHERMAN TX
75090
US

IV. Provider business mailing address

2800 W LANCASTER AVE
FORT WORTH TX
76107-3007
US

V. Phone/Fax

Practice location:
  • Phone: 903-891-1730
  • Fax: 903-891-1703
Mailing address:
  • Phone: 817-681-4811
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number118941
License Number StateTX

VIII. Authorized Official

Name: FREDERICK CERISE
Title or Position: PRESIDENT & CEO
Credential: MD
Phone: 214-590-8006