Provider Demographics
NPI:1417132127
Name:NORTH TEXAS HEALTH CARE SYSTEM
Entity Type:Organization
Organization Name:NORTH TEXAS HEALTH CARE SYSTEM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RECREATION THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:CLYDE
Authorized Official - Middle Name:LOUIS
Authorized Official - Last Name:DEERE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-857-1134
Mailing Address - Street 1:4500 S LANCASTER RD # 11K
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75216-7167
Mailing Address - Country:US
Mailing Address - Phone:214-857-1270
Mailing Address - Fax:214-302-1358
Practice Address - Street 1:4500 S LANCASTER RD # 11K
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:214-857-1270
Practice Address - Fax:214-302-1358
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-02
Last Update Date:2008-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes286500000XHospitalsMilitary Hospital