Provider Demographics
NPI:1790971612
Name:RENAISSANCE HOSPITAL DALLAS
Entity Type:Organization
Organization Name:RENAISSANCE HOSPITAL DALLAS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:SMESNY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-886-1900
Mailing Address - Street 1:14440 JOHN F KENNEDY BLVD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77032-5300
Mailing Address - Country:US
Mailing Address - Phone:832-886-1900
Mailing Address - Fax:281-227-1142
Practice Address - Street 1:2929 S HAMPTON RD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75224-3026
Practice Address - Country:US
Practice Address - Phone:214-623-4400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-25
Last Update Date:2007-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX008229282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital