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Organization

DALLAS COUNTY HOSPITAL DISTRICT

Active
Other names
Jubilee Park Community Clinic
Organization subpart
No

Provider details

NPI number
Authorized official
FREDERICK CERISE (PRESIDENT AND CEO)
(214) 590-8006
Entity
Organization

Contact information

Practice address
820 ANN AVE, DALLAS, TX 75223-2716
(214) 590-7300
Mailing address
PO BOX 660599, DALLAS, TX 75266-0599

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
207Q00000X
Family Medicine Physician
Primary
207R00000X
Internal Medicine Physician
208000000X
Pediatrics Physician

Other

Enumeration date
07/18/2022
Last updated
12/07/2022
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