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	4633300005	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	4589872	OTHER	TX	NCPDP

General Provider Information

NPI Number	:	1649264391
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	:	9202 ELAM RD
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75217-4151
Country	:	US
Telephone Number	:	214-590-1766
Fax Number	:

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

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

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1841274578 — ADEOLA A. AMUSAN MD
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1801870449 — SUNTI S. SRIVATHANAKUL MD
Practice Location Address:

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1083698641 — NUSRAT T. ALAMGIR MD
Practice Location Address:

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Practice Fax: 214-266-1790

Directions to “DALLAS COUNTY HOSPITAL DISTRICT ” Practice Location

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