Provider Demographics
NPI:1447217609
Name:REGENCY HOSPITAL OF NORTH DALLAS, LLLP
Entity Type:Organization
Organization Name:REGENCY HOSPITAL OF NORTH DALLAS, LLLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF STRATEGY OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:W.
Authorized Official - Middle Name:GENE
Authorized Official - Last Name:WINTERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-777-2602
Mailing Address - Street 1:11175 CICERO DRIVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30022-1584
Mailing Address - Country:US
Mailing Address - Phone:770-772-4345
Mailing Address - Fax:
Practice Address - Street 1:2225 PARKER ROAD
Practice Address - Street 2:
Practice Address - City:CARRROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75101
Practice Address - Country:US
Practice Address - Phone:972-236-6800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282E00000XHospitalsLong Term Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
67-0013Medicare ID - Type Unspecified