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NPI Code Detail

MEDICARE: HENRY C. DEES JR. ACNP

MEDICARE: HENRY C. DEES JR. ACNP
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
1363LA2100XAcute Care Nurse Practitioner600761TX
2363LA2100XAcute Care Nurse PractitionerAP111360TX

Other Identifiers

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

General Provider Information

NPI Number : 1659371375
Entity Type Code : Individual
Provider Name (Legal Business Name) : HENRY C. DEES JR. ACNP
Provider Business Mailing Address
First Line : PO BOX 660599
Second Line :
City : DALLAS
State : TX
Zip : 75266-0599
Country : US
Telephone Number : 214-590-4105
Fax Number : 214-590-4162
Provider Business Practice Location Address
First Line : 1004 S CARRIER PKWY
Second Line :
City : GRAND PRAIRIE
State : TX
Zip : 75051-1527
Country : US
Telephone Number : 214-677-1300
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/22/2005
Last Update Date : 09/21/2022

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