Basic Information
| Provider Information | |||||||||
| NPI: | 1184911521 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | METHODIST HOSPITALS OF DALLAS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1441 N BECKLEY AVE | ||||||||
| Address2: | |||||||||
| City: | DALLAS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 752031201 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2149478181 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1441 N BECKLEY AVE | ||||||||
| Address2: | |||||||||
| City: | DALLAS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 752031201 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2149472315 | ||||||||
| FaxNumber: | 2149472361 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/06/2011 | ||||||||
| LastUpdateDate: | 07/06/2011 | ||||||||
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| AuthorizedOfficialLastName: | SCHAEF | ||||||||
| AuthorizedOfficialFirstName: | MR. MICHAEL | ||||||||
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| AuthorizedOfficialTitleorPosition: | EXEC VP &CHIEF FINANCIAL OFFICER | ||||||||
| AuthorizedOfficialTelephone: | 2149474510 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MISS | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 282N00000X | Y | Hospitals | General Acute Care Hospital |
ID Information
| ID | Type | State | Issuer | Description | 135032405 | 05 | TX | MEDICAID |