Organization
DALLAS COUNTY HOSPITAL DISTRICT
Active
Organization
DALLAS COUNTY HOSPITAL DISTRICT
Active
Other names
E. Carlyle Smith, Jr. Health Center
Organization subpart
No
Provider details
NPI number
Authorized official
FREDERICK CERISE (PRESIDENT AND CEO)
(214) 590-8006
Entity
Organization
Contact information
Practice address
801 CONOVER DR, GRAND PRAIRIE, TX 75051-1519
(214) 266-3400
Mailing address
PO BOX 660599, DALLAS, TX 75266-0599
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
—
—
103TC0700X
Clinical Psychologist
—
—
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
—
—
208000000X
Pediatrics Physician
—
—
2084P0800X
Psychiatry Physician
—
—
363A00000X
Physician Assistant
—
—
363LP0200X
Pediatric Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
304256601
—
TX
05
—
304256602
—
TX
Enumeration date
03/12/2012
Last updated
12/19/2022
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