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General NPI Number Information
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NPI Number | 1366539272
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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 | 10/10/2006
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Last Update Date | 06/29/2016
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Provider Practice Location Address
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Address Line | 2600 N STEMMONS FWY STE 151
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City | DALLAS
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State | TX
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Zip | 75207-2111
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Country | US
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Telephone | 214-743-1229
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Fax | 214-905-9178
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Provider Business Mailing Address
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Address Line | 2600 N STEMMONS FWY STE 151
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City | DALLAS
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State | TX
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Zip | 75207-2111
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Country | US
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Telephone | 214-743-1229
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Fax | 214-905-9178
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Authorized Official
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Title or Position | DIRECTOR
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Name | MARK EDERY
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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 | 3336C0002X
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Taxonomy Name | Clinic Pharmacy
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License Number | 2205
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License Number State | TX
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