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General NPI Number Information
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NPI Number | 1306246152
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Entity Type | Organization
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Legal Business Name | DOCTORS HOSPITAL AT WHITE ROCK LAKE
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Dates
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Enumeration Date | 08/29/2014
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Last Update Date | 08/29/2014
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Provider Practice Location Address
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Address Line | 9330 POPPY DR STE 100
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City | DALLAS
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State | TX
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Zip | 75218-4622
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Country | US
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Telephone | 214-324-6000
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Fax | 214-324-6297
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Provider Business Mailing Address
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Address Line | 9330 POPPY DR STE 100
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City | DALLAS
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State | TX
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Zip | 75218-4622
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Country | US
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Telephone | 214-324-6000
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Fax | 214-324-6297
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Authorized Official
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Title or Position | REHABILITATION SERVICES DIRECTOR
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Name | KERI WALAKOVITS
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Credential |
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Telephone | 214-324-6000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | 1141984
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License Number State | TX
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