Provider Demographics
NPI:1073621306
Name:NORTH TEXAS HEALTH CARE SYSTEM
Entity Type:Organization
Organization Name:NORTH TEXAS HEALTH CARE SYSTEM
Other - Org Name:DALLAS VA MEDICAL CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:FAMILY NURSE PRACTITIONER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:GLENN
Authorized Official - Suffix:
Authorized Official - Credentials:APN
Authorized Official - Phone:214-742-8387
Mailing Address - Street 1:3814 BACHMAN BLVD
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75043-1901
Mailing Address - Country:US
Mailing Address - Phone:214-742-8387
Mailing Address - Fax:214-462-4986
Practice Address - Street 1:4500 S LANCASTER RD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75216-7167
Practice Address - Country:US
Practice Address - Phone:214-742-8387
Practice Address - Fax:214-462-4986
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX235579282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital