MEDICARE: DALLAS HEALTHY START

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	251B00000X	Case Management Agency	553655	TX

General Provider Information

NPI Number	:	1346526159
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DALLAS HEALTHY START

Provider Business Mailing Address
First Line	:	4917 HARRY HINES BLVD
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75235-7718
Country	:	US
Telephone Number	:	214-590-1670
Fax Number	:

Provider Business Practice Location Address
First Line	:	4917 HARRY HINES BLVD
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75235-7718
Country	:	US
Telephone Number	:	214-590-1670
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	EULALIA GUILLUM-ROBERSON
Credential	:
Telephone Number	:	214-590-1670

Provider Enumeration Date	:	10/25/2011
Last Update Date	:	10/25/2011

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Directions to “DALLAS HEALTHY START ” Practice Location

Language	Start Address	Practice Location

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