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General NPI Number Information
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NPI Number | 1528081429
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Entity Type | Organization
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Legal Business Name | VISTA HOSPITAL OF DALLAS
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Dates
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Enumeration Date | 07/25/2006
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Last Update Date | 02/03/2009
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Provider Practice Location Address
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Address Line | 2696 W WALNUT ST
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City | GARLAND
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State | TX
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Zip | 75042-6441
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Country | US
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Telephone | 713-378-3000
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Fax | 713-378-3104
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Provider Business Mailing Address
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Address Line | PO BOX DEPT 802-3 4346
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City | HOUSTON
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State | TX
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Zip | 77210-4346
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Country | US
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Telephone | 713-378-3000
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Fax | 713-378-3104
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Authorized Official
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Title or Position | FINANCIAL BUSINESS SERVICES DIRECTO
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Name | MS. JACQUELYN N PHAM
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Credential |
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Telephone | 713-378-3000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | 000359
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License Number State | TX
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