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General NPI Number Information
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NPI Number | 1831308261
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Entity Type | Organization
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Legal Business Name | DALLAS VA MEDICAL CENTER
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Dates
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Enumeration Date | 05/22/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 4500 S LANCASTER ROAD
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City | DALLAS
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State | TX
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Zip | 75216
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Country | US
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Telephone | 214-857-1763
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Fax |
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Provider Business Mailing Address
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Address Line | 5200 TOWN AND COUNTRY APT 513
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City | FRISCO
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State | TX
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Zip | 75034
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Country | US
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Telephone | 214-886-8950
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Fax |
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Authorized Official
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Title or Position | STAFF RN
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Name | MR. JOHN DENNIS ALDRIDGE
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Credential |
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Telephone | 214-857-1763
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 273Y00000X
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Taxonomy Name | Rehabilitation Hospital Unit
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License Number | 646183
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License Number State | TX
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