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General NPI Number Information
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NPI Number | 1336396274
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Entity Type | Organization
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Legal Business Name | DENTON REGIONAL MEDICAL CENEER
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Dates
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Enumeration Date | 08/21/2008
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Last Update Date | 08/21/2008
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Provider Practice Location Address
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Address Line | 1333 SKILES ST
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City | DALLAS
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State | TX
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Zip | 75204-6108
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Country | US
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Telephone | 214-529-5266
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Fax |
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Provider Business Mailing Address
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Address Line | 1333 SKILES ST
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City | DALLAS
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State | TX
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Zip | 75204-6108
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Country | US
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Telephone | 214-823-6964
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Fax | 214-823-6964
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Authorized Official
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Title or Position | DIRECTOR OF FOOD AND NUTRITION
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Name | SHAKIL MUKADAM
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Credential | LD, CDM, CFM
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Telephone | 214-823-6964
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282NR1301X
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Taxonomy Name | Rural Acute Care Hospital
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License Number | 17828847
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License Number State | TX
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