Provider Demographics
NPI:1619981917
Name:DALLAS HEALTHCARE SYSTEMS INC
Entity Type:Organization
Organization Name:DALLAS HEALTHCARE SYSTEMS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAN
Authorized Official - Middle Name:IBE
Authorized Official - Last Name:UGWUZOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-248-0538
Mailing Address - Street 1:15201 EAST FWY
Mailing Address - Street 2:STE 114
Mailing Address - City:CHANNELVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:77530-4131
Mailing Address - Country:US
Mailing Address - Phone:281-457-2414
Mailing Address - Fax:281-457-2429
Practice Address - Street 1:15201 EAST FWY
Practice Address - Street 2:STE 114
Practice Address - City:CHANNELVIEW
Practice Address - State:TX
Practice Address - Zip Code:77530-4131
Practice Address - Country:US
Practice Address - Phone:281-457-2414
Practice Address - Fax:281-457-2429
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-29
Last Update Date:2008-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1425362Medicaid
LA1425362Medicaid