Provider Demographics
NPI:1972795730
Name:DALLAS MEDICAL CENTER LLC
Entity Type:Organization
Organization Name:DALLAS MEDICAL CENTER LLC
Other - Org Name:DALLAS MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:KATHERINE
Authorized Official - Middle Name:G
Authorized Official - Last Name:LOWER
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:214-683-5915
Mailing Address - Street 1:7 MEDICAL PKWY
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75234-7829
Mailing Address - Country:US
Mailing Address - Phone:972-247-1000
Mailing Address - Fax:972-888-7090
Practice Address - Street 1:7 MEDICAL PKWY
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75234-7829
Practice Address - Country:US
Practice Address - Phone:972-247-1000
Practice Address - Fax:972-888-7090
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-15
Last Update Date:2011-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273R00000XHospital UnitsPsychiatric Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX45S379Medicare Oscar/Certification