Basic Information
Provider Information
NPI: 1184029811
EntityType: 2
ReplacementNPI:  
OrganizationName: SELECT SPECIALTY HOSPITAL DALLAS INC
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Mailing Information
Address1: 4714 GETTYSBURG RD
Address2: LEGAL DEPT
City: MECHANICSBURG
State: PA
PostalCode: 170554325
CountryCode: US
TelephoneNumber: 7179721100
FaxNumber:  
Practice Location
Address1: 3500 GASTON AVE
Address2: 3RD AND 4TH FLOORS
City: DALLAS
State: TX
PostalCode: 752462017
CountryCode: US
TelephoneNumber: 7179721100
FaxNumber:  
Other Information
ProviderEnumerationDate: 10/23/2014
LastUpdateDate: 12/02/2015
NPIDeactivationReasonCode:  
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AuthorizedOfficialLastName: TARVIN
AuthorizedOfficialFirstName: MICHAEL
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AuthorizedOfficialTitleorPosition: VP
AuthorizedOfficialTelephone: 7179721100
IsSoleProprietor:  
IsOrganizationSubpart: N
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Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
282E00000X  Y HospitalsLong Term Care Hospital 

No ID Information.


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