Organization
SELECT SPECIALTY HOSPITAL - SOUTH DALLAS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL E. TARVIN (VICE PRESIDENT)
(717) 972-1100
Entity
Organization
Contact information
Practice address
3500 W WHEATLAND RD, 4TH FLOOR, DALLAS, TX 75237-3460
(972) 780-6514
(972) 298-4860
Mailing address
4714 GETTYSBURG RD, LEGAL DEPT., MECHANICSBURG, PA 17055-4325
(717) 972-1100
(717) 975-9981
Taxonomy
Speciality
Code
Description
License number
State
282E00000X
Long Term Care Hospital
Primary
007859
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
HH1028
BCBS TX
TX
Enumeration date
07/27/2005
Last updated
06/14/2012
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