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General NPI Number Information
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NPI Number | 1689073470
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Entity Type | Organization
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Legal Business Name | GREATER DALLAS HEALTHCARE ENTERPRISES
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Dates
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Enumeration Date | 08/18/2014
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Last Update Date | 06/07/2016
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Provider Practice Location Address
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Address Line | 6301 GASTON AVE SUITE 190P
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City | DALLAS
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State | TX
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Zip | 75214-3922
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Country | US
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Telephone | 469-619-6550
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Fax | 469-334-0507
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Provider Business Mailing Address
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Address Line | PO BOX 840711
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City | DALLAS
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State | TX
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Zip | 75284-0711
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Country | US
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Telephone | 469-619-6550
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Fax | 469-334-0507
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Authorized Official
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Title or Position | SVP REGIONAL OPERATIONS, TENET
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Name | MR. TIMOTHY ADAMS
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Credential |
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Telephone | 469-893-2563
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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