Organization
DALLAS COUNTY HOSPITAL DISTRICT
Active
Organization
DALLAS COUNTY HOSPITAL DISTRICT
Active
Other names
Southeast Dallas Health Center
Organization subpart
No
Provider details
NPI number
Authorized official
FREDERICK P. CERISE M.D. (PRESIDENT & CHIEF EXECUTIVE OFFICER)
(214) 590-8006
Entity
Organization
Contact information
Practice address
9202 ELAM RD, DALLAS, TX 75217-4151
(214) 266-1600
Mailing address
PO BOX 660599, DALLAS, TX 75266-0599
(214) 590-4105
(214) 590-4162
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
208000000X
Pediatrics Physician
—
—
363L00000X
Nurse Practitioner
—
—
363LF0000X
Family Nurse Practitioner
—
—
363LG0600X
Gerontology Nurse Practitioner
—
—
363LW0102X
Women's Health Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
080011201
—
TX
05
—
080011202
—
TX
05
—
133247006
—
TX
Enumeration date
06/30/2006
Last updated
12/07/2022
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