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Organization
CHILDRENS MEDICAL CENTER DALLAS
Active
Organization
CHILDRENS MEDICAL CENTER DALLAS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. STEPHANIE DETAMORE ATHRE RN, MSN CPNP (NURSE PRACTITIONER)
(214) 456-5614
Entity
Organization
Contact information
Practice address
1935 MOTOR ST, DALLAS, TX 75235-7701
(214) 456-5614
Mailing address
5060 WATEKA DR, DALLAS, TX 75209-4825
(214) 353-2775
(214) 456-5071
Taxonomy
Speciality
Code
Description
License number
State
282NC2000X
Children's Hospital
Primary
630600
TX
Other
Enumeration date
01/03/2007
Last updated
08/22/2020
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