1932230836 NPI number — DALLAS COUNTY HOSPITAL DISTRICT

Table of content: (NPI 1932230836)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1932230836 NPI number — DALLAS COUNTY HOSPITAL DISTRICT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DALLAS COUNTY HOSPITAL DISTRICT
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
BLUITT FLOWERS HEALTH CENTER
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1932230836
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/28/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5200 HARRY HINES BLVD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DALLAS
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75235-7709
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
214-590-8714
Provider Business Mailing Address Fax Number:
469-419-3023

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
303 E OVERTON RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DALLAS
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75216-5946
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
214-266-4294
Provider Business Practice Location Address Fax Number:
214-266-4292
Provider Enumeration Date:
03/09/2007

Additional Information

Authorized Official

Authorized Official Last Name:
LOPEZ
Authorized Official First Name:
DAVID
Authorized Official Middle Name:
S
Authorized Official Title or Position:
CHIEF OPERATING OFFICER
Authorized Official Telephone Number:
214-590-4085

Provider Taxonomy Codes

  • Taxonomy code: 3336C0002X , with the licence number:  14442 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 2100558 . This is a "PK" identifier . This identifiers is of the category "OTHER".
  • Identifier: 251050 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2024 www.npivalidator.com