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General NPI Number Information
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NPI Number | 1770634115
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Entity Type | Organization
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Legal Business Name | DALLAS VETERANS AFFAIRS MEDICAL CENTER
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Dates
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Enumeration Date | 01/14/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1401 W JEFFERSON BLVD
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City | DALLAS
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State | TX
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Zip | 75208-5326
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Country | US
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Telephone | 214-415-3804
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Fax |
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Provider Business Mailing Address
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Address Line | 1713 WALNUT HILL DR
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City | ROWLETT
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State | TX
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Zip | 75088-1552
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Country | US
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Telephone | 214-284-4112
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Fax |
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Authorized Official
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Title or Position | NURSE PRACTITIONER
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Name | MS. YOLANDA VELEZ-REYNA
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Credential | F.N.P.
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Telephone | 214-857-0497
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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 | 573378
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License Number State | TX
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