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General NPI Number Information
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NPI Number | 1194728220
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Entity Type | Organization
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Legal Business Name | DALLAS COUNTY HOSPITAL DISTRICT
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Dates
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Enumeration Date | 05/23/2005
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Last Update Date | 10/30/2023
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Provider Practice Location Address
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Address Line | 3345 MEDPARK DR.
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City | DENTON
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State | TX
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Zip | 76210
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Country | US
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Telephone | 940-387-8508
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Fax | 940-898-8761
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Provider Business Mailing Address
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Address Line | 3345 MEDPARK DR.
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City | DENTON
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State | TX
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Zip | 76210
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Country | US
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Telephone | 940-387-8508
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Fax | 940-898-8761
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Authorized Official
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Title or Position | CEO
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Name | FREDERICK CERISE
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Credential |
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Telephone | 214-590-8006
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 675136
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License Number State | TX
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