Provider Demographics
NPI:1568481489
Name:TENET HEALTHSYSTEM HOSPITALS DALLAS, INC.
Entity type:Organization
Organization Name:TENET HEALTHSYSTEM HOSPITALS DALLAS, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VP OF TAXATION, TENET HEALTHCARE
Authorized Official - Prefix:MR
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:E
Authorized Official - Last Name:RABE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-893-2530
Mailing Address - Street 1:PO BOX 849992
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-9992
Mailing Address - Country:US
Mailing Address - Phone:214-387-6444
Mailing Address - Fax:972-394-4783
Practice Address - Street 1:4343 N JOSEY LN
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75010-4603
Practice Address - Country:US
Practice Address - Phone:972-492-1010
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX000042261QR1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
45-8678Medicare ID - Type UnspecifiedRHC