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Organization
DALLAS COUNTY HOSPITAL DISTRICT
Active
Organization
DALLAS COUNTY HOSPITAL DISTRICT
Active
Other names
Mira Vista Court
Organization subpart
No
Provider details
NPI number
Authorized official
FREDERICK CERISE MD (CEO)
(214) 590-8006
Entity
Organization
Contact information
Practice address
7021 BRYANT IRVIN RD, FORT WORTH, TX 76132-4243
(817) 361-1400
(817) 361-1400
Mailing address
7021 BRYANT IRVIN RD, FORT WORTH, TX 76132-4243
(817) 361-1400
(817) 361-1400
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001026572
—
TX
Enumeration date
01/15/2015
Last updated
03/16/2017
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