Organization
DALLAS COUNTY HOSPITAL DISTRICT
Active
Other names
E. Carlyle Smith, Jr. Women's Health Center
Organization subpart
No
Provider details
NPI number
Authorized official
FREDERICK P. CERISE (PRESIDENT & CEO)
(214) 590-8006
Entity
Organization
Contact information
Practice address
801 CONOVER DR, GRAND PRAIRIE, TX 75051-1519
(214) 266-3500
Mailing address
PO BOX 660599, DALLAS, TX 75266-0599
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
—
—
363L00000X
Nurse Practitioner
—
—
363LF0000X
Family Nurse Practitioner
—
—
363LW0102X
Women's Health Nurse Practitioner
Primary
—
—
367A00000X
Advanced Practice Midwife
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
298058301
—
TX
05
—
298058302
—
TX
Enumeration date
03/27/2012
Last updated
12/19/2022
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