Provider Demographics
NPI:1740227495
Name:COUNTY OF DALLAS
Entity Type:Organization
Organization Name:COUNTY OF DALLAS
Other - Org Name:DALLAS COUNTY DEPT. OF HEALTH & HUMAN SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ZACHARY
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-819-2101
Mailing Address - Street 1:2377 N STEMMONS FWY
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75207-2710
Mailing Address - Country:US
Mailing Address - Phone:214-819-2109
Mailing Address - Fax:214-819-2107
Practice Address - Street 1:2377 N STEMMONS FWY
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75207-2710
Practice Address - Country:US
Practice Address - Phone:214-819-1819
Practice Address - Fax:214-819-6057
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-01
Last Update Date:2013-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
208000000X, 2083P0901X, 251K00000X, 261QM2500X, 261QP0905X
TXR11347261QR0200X
TX45D0672012291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive MedicineGroup - Multi-Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
No251K00000XAgenciesPublic Health or Welfare
No261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
No261QP0905XAmbulatory Health Care FacilitiesClinic/CenterPublic Health, State or Local
No261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
No291U00000XLaboratoriesClinical Medical LaboratoryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX121758005Medicaid
TX121758002Medicaid
TX018400401Medicaid
TX065090501Medicaid
TX065090501Medicaid