MEDICARE: DALLAS COUNTY HOSPITAL DISTRICT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	333600000X	Pharmacy	4633300004	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	4596613	OTHER	TX	NCPDP

General Provider Information

NPI Number	:	1326032079
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DALLAS COUNTY HOSPITAL DISTRICT

Provider Business Mailing Address
First Line	:	5200 HARRY HINES BLVD
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75235-7709
Country	:	US
Telephone Number	:	469-419-1976
Fax Number	:	469-419-6210

Provider Business Practice Location Address
First Line	:	802 HOPKINS ST
Second Line	:
City	:	GARLAND
State	:	TX
Zip	:	75040-7379
Country	:	US
Telephone Number	:	469-419-1976
Fax Number	:	469-419-6210

Authorized Official
Title or Position	:	EXECUTIVE VP & CHIEF OPERATING OFC
Name	:	EDMUNDO CASTANEDA
Credential	:
Telephone Number	:	214-590-8006

Provider Enumeration Date	:	09/08/2005
Last Update Date	:	06/03/2024

Similar Medicare Providers

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Practice Location Address:

802 HOPKINS ST
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1073597464 — DR. DONNA I. PERSAUD MD
Practice Location Address:

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1710961883 — PANKAJ C. PATEL MD
Practice Location Address:

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Directions to “DALLAS COUNTY HOSPITAL DISTRICT ” Practice Location

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