Organization
DALLAS COUNTY HOSPITAL DISTRICT
Active
Other names
The Plaza at Richardson
Organization subpart
No
Provider details
NPI number
Authorized official
FREDERICK CERISE MD (CEO)
(214) 590-8006
Entity
Organization
Contact information
Practice address
1301 RICHARDSON DR, RICHARDSON, TX 75080-4648
(972) 759-2180
(972) 759-2186
Mailing address
8505 TECHNOLOGY FOREST PL STE 1004, THE WOODLANDS, TX 77381-1186
(832) 489-9944
(866) 354-8161
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
116913
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001021316
—
TX
05
—
001026660
—
TX
01
—
180187001
MEDICAID CO B
TX
Enumeration date
04/11/2006
Last updated
06/09/2020
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