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NPI Code Detail

MEDICARE: DALLAS VAMC

MEDICARE: DALLAS VAMC
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
1261QV0200XVA Clinic/Center

General Provider Information

NPI Number : 1649645672
Entity Type Code : Organization
Provider Name (Legal Business Name) : DALLAS VAMC
Provider Business Mailing Address
First Line : PO BOX 94493
Second Line :
City : CLEVELAND
State : OH
Zip : 44101
Country : US
Telephone Number : 615-355-3451
Fax Number :
Provider Business Practice Location Address
First Line : 101 NEW YORK AVE
Second Line :
City : FORT WORTH
State : TX
Zip : 76104-1558
Country : US
Telephone Number : 615-355-3451
Fax Number :
Authorized Official
Title or Position : NPI TEAM MEMBER
Name : ERIN POTTER
Credential :
Telephone Number : 202-382-2579
Provider Enumeration Date : 12/02/2015
Last Update Date : 01/18/2022

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Directions to “DALLAS VAMC ” Practice Location

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