Provider Demographics
NPI:1831140698
Name:GREEN OAKS HOSPITAL SUBSIDIARY LP
Entity Type:Organization
Organization Name:GREEN OAKS HOSPITAL SUBSIDIARY LP
Other - Org Name:MEDICAL CITY GREEN OAKS HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:DEDE
Authorized Official - Middle Name:
Authorized Official - Last Name:ARNOLD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-701-3656
Mailing Address - Street 1:7808 CLODUS FIELDS DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75251-2206
Mailing Address - Country:US
Mailing Address - Phone:972-991-9504
Mailing Address - Fax:972-991-2417
Practice Address - Street 1:7808 CLODUS FIELDS DR
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75251-2206
Practice Address - Country:US
Practice Address - Phone:972-991-9504
Practice Address - Fax:972-991-2417
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-15
Last Update Date:2023-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283Q00000XHospitalsPsychiatric Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX021224301Medicaid
166508400OtherDEPT OF LABOR
ORHH6547OtherBLUE CROSS-PSYC DAY TRMT
166508400OtherDEPT OF LABOR
=========OtherTRICARE