Organization
DALLAS COUNTY HOSPITAL DISTRICT
Active
Other names
Center for Geriatric Care & Healthy Aging
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
2231 BUTLER ST STE 150, DALLAS, TX 75235-7826
(214) 590-8369
Mailing address
PO BOX 660599, DALLAS, TX 75266-0599
Taxonomy
Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
—
—
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
—
—
363L00000X
Nurse Practitioner
—
—
363LA2200X
Adult Health Nurse Practitioner
—
—
363LF0000X
Family Nurse Practitioner
—
—
363LG0600X
Gerontology Nurse Practitioner
—
—
364S00000X
Clinical Nurse Specialist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
146794602
—
TX
Enumeration date
06/15/2006
Last updated
10/18/2024
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