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NPI Code Detail

MEDICARE: METHODIST HOSPITALS OF DALLAS

MEDICARE: METHODIST HOSPITALS OF DALLAS
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
1261QA1903XAmbulatory Surgical Clinic/Center
2282N00000XGeneral Acute Care Hospital

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 : 1689629941
Entity Type Code : Organization
Provider Name (Legal Business Name) : METHODIST HOSPITALS OF DALLAS
Provider Business Mailing Address
First Line : PO BOX 911875
Second Line :
City : DALLAS
State : TX
Zip : 75391-1875
Country : US
Telephone Number : 682-242-2000
Fax Number :
Provider Business Practice Location Address
First Line : 2700 E BROAD ST
Second Line :
City : MANSFIELD
State : TX
Zip : 76063-5899
Country : US
Telephone Number : 682-622-2000
Fax Number :
Authorized Official
Title or Position : EXECUTIVE VP & CFO
Name : CRAIG ALLEN BJERKE
Credential :
Telephone Number : 214-947-4512
Provider Enumeration Date : 05/24/2006
Last Update Date : 06/12/2024

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Directions to “METHODIST HOSPITALS OF DALLAS ” Practice Location

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