Organization
DALLAS COUNTY HOSPITAL DISTRICT
Active
Other names
Pediatric Primary Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
FREDRICK P. CERISE M.D. (PRESIDENT & CHIEF EXECUTIVE OFFICER)
(214) 590-8006
Entity
Organization
Contact information
Practice address
5151 MAPLE AVE # 6B, DALLAS, TX 75235-8136
(214) 266-0110
(214) 266-0113
Mailing address
PO BOX 660599, DALLAS, TX 75266-0599
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
363LP0200X
Pediatric Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
111924001
—
TX
05
—
111924002
—
TX
05
—
133247005
—
TX
Enumeration date
06/04/2006
Last updated
07/10/2023
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
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