Organization · NPI-2

Dallas County Hospital District

Internal Medicine · Grand Prairie, TX

NPI number1194090001

StatusActive

Last updated in NPPESDec 19, 2022

Details

NPI: 1194090001
Entity type: Organization (NPI-2)
Legal business name: Dallas County Hospital District
Organization subpart: No
Enumeration date: Mar 12, 2012
Certification date: Dec 19, 2022
Last updated: Dec 19, 2022

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
207R00000X	Internal Medicine	–	–	Yes
103T00000X	Psychologist	–	–
103TC0700X	Psychologist, Clinical	–	–
207Q00000X	Family Medicine	–	–
207RG0300X	Internal Medicine, Geriatric Medicine	–	–
208000000X	Pediatrics	–	–
2084P0800X	Psychiatry & Neurology, Psychiatry	–	–
363A00000X	Physician Assistant	–	–
363LP0200X	Nurse Practitioner, Pediatrics	–	–

Other names

E. Carlyle Smith, Jr. Health Center (Doing Business As)

Practice location

801 Conover Dr
Grand Prairie, TX 75051-1519

Phone 214-266-3400

Mailing address

Po Box 660599
Dallas, TX 75266-0599

Authorized official

Frederick Cerise
President And Ceo
2145908006

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