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General NPI Number Information
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NPI Number | 1093114134
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Entity Type | Organization
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Legal Business Name | DALLAS COUNTY MENTAL HEALTH & MENTAL RETARDATION CENTER
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Dates
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Enumeration Date | 08/14/2014
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Last Update Date | 12/02/2025
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Provider Practice Location Address
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Address Line | 1020 S CARRIER PKWY
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City | GRAND PRAIRIE
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State | TX
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Zip | 75051-1527
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Country | US
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Telephone | 214-330-2424
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Fax | 214-330-2422
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Provider Business Mailing Address
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Address Line | 3242 REMOND DR ATTN: PHARMACY
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City | DALLAS
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State | TX
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Zip | 75211
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Country | US
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Telephone | 214-743-6180
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Fax | 469-200-1956
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Authorized Official
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Title or Position | CHIEF PHARMACY OFFICER
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Name | MIN SEO CHEON KIM
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Credential |
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Telephone | 214-743-6180
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0002X
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Taxonomy Name | Clinic Pharmacy
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License Number | 29414
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License Number State | TX
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