Provider Demographics
NPI:1942600838
Name:DALLAS COUNTY HOSPITAL DISTRICT
Entity Type:Organization
Organization Name:DALLAS COUNTY HOSPITAL DISTRICT
Other - Org Name:THE HILLCREST OF NORTH DALLAS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SR VP
Authorized Official - Prefix:
Authorized Official - First Name:MARILYN
Authorized Official - Middle Name:
Authorized Official - Last Name:CALLIES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-419-0317
Mailing Address - Street 1:18648 HILLCREST RD
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75252-2752
Mailing Address - Country:US
Mailing Address - Phone:972-517-7771
Mailing Address - Fax:972-517-7779
Practice Address - Street 1:18648 HILLCREST RD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75252-2752
Practice Address - Country:US
Practice Address - Phone:972-517-7771
Practice Address - Fax:972-517-7779
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-27
Last Update Date:2022-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX001026122Medicaid
676315Medicare Oscar/Certification