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General NPI Number Information
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NPI Number | 1619508728
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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 | 01/28/2020
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Last Update Date | 12/07/2022
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Provider Practice Location Address
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Address Line | 4201 BROOK SPRING DR BLDG 2
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City | DALLAS
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State | TX
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Zip | 75224-4968
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Country | US
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Telephone | 214-266-4050
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 660599
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City | DALLAS
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State | TX
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Zip | 75266-0599
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT AND CHIEF EXECUTIVE OFFIC
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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 | 261QE0700X
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Taxonomy Name | End-Stage Renal Disease (ESRD) Treatment Clinic/Center
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License Number |
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License Number State |
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