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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