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
1	207Q00000X	Family Medicine Physician
2	208000000X	Pediatrics Physician
3	213E00000X	Podiatrist
4	363A00000X	Physician Assistant
5	363L00000X	Nurse Practitioner
6	207R00000X	Internal Medicine Physician
7	261QF0400X	Federally Qualified Health Center (FQHC)

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1356852784
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DALLAS COUNTY HOSPITAL DISTRICT

Provider Business Mailing Address
First Line	:	PO BOX 660599
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75266-0599
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1822 YOUNG ST
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75201-5612
Country	:	US
Telephone Number	:	214-590-0153
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT & CHIEF EXECUTIVE OFFICER
Name	:	FREDERICK P. CERISE
Credential	:
Telephone Number	:	214-590-8006

Provider Enumeration Date	:	10/12/2017
Last Update Date	:	06/17/2025

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Directions to “DALLAS COUNTY HOSPITAL DISTRICT ” Practice Location

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