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Organization
DALLAS COUNTY HOSPITAL DISTRICT
Active
Organization
DALLAS COUNTY HOSPITAL DISTRICT
Active
Other names
The Plaza at Richardson
Organization subpart
No
Provider details
NPI number
Authorized official
FREDERICK CERISE MD (CEO)
(214) 590-8006
Entity
Organization
Contact information
Practice address
1301 RICHARDSON DR, RICHARDSON, TX 75080-4648
(972) 759-2180
(972) 759-2186
Mailing address
8505 TECHNOLOGY FOREST PL STE 1004, THE WOODLANDS, TX 77381-1186
(832) 489-9944
(866) 354-8161
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
116913
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001021316
—
TX
05
—
001026660
—
TX
01
—
180187001
MEDICAID CO B
TX
Enumeration date
04/11/2006
Last updated
06/09/2020
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