Organization
CHILDRENS MEDICAL CENTER DALLAS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. STEPHANIE DETAMORE ATHRE RN, MSN CPNP (NURSE PRACTITIONER)
(214) 456-5614
Entity
Organization
Contact information
Practice address
1935 MOTOR ST, DALLAS, TX 75235-7701
(214) 456-5614
Mailing address
5060 WATEKA DR, DALLAS, TX 75209-4825
(214) 353-2775
(214) 456-5071
Taxonomy
Speciality
Code
Description
License number
State
282NC2000X
Children's Hospital
Primary
630600
TX
Other
Enumeration date
01/03/2007
Last updated
08/22/2020
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