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General NPI Number Information
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NPI Number | 1932336476
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Entity Type | Organization
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Legal Business Name | DALLAS HEALTHCARE FOR CHILDREN
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Dates
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Enumeration Date | 06/11/2009
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Last Update Date | 04/02/2014
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Provider Practice Location Address
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Address Line | 4131 S BUCKNER BLVD SUITE A
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City | DALLAS
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State | TX
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Zip | 75227-4336
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Country | US
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Telephone | 214-388-0202
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Fax |
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Provider Business Mailing Address
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Address Line | 4131 S BUCKNER BLVD SUITE A
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City | DALLAS
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State | TX
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Zip | 75227-4318
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Country | US
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Telephone | 214-388-0202
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. STEPHANIE ANN PORTER
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Credential | M.D.
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Telephone | 214-388-0202
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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 | L3841
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License Number State | TX
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