Basic Information
| Provider Information | |||||||||
| NPI: | 1073538914 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | DALLAS METROCARE SERVICES | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1353 N WESTMORELAND RD BLDG B | ||||||||
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| City: | DALLAS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 752111655 | ||||||||
| CountryCode: | US | ||||||||
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| Address1: | 1353 N WESTMORELAND RD BLDG B | ||||||||
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| City: | DALLAS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 752111655 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2143310107 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/13/2006 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | LANGHAM JR | ||||||||
| AuthorizedOfficialFirstName: | THOMAS | ||||||||
| AuthorizedOfficialMiddleName: | W | ||||||||
| AuthorizedOfficialTitleorPosition: | ADVANCED PRACTICE NURSE | ||||||||
| AuthorizedOfficialTelephone: | 2143310107 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | RN APN | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251J00000X | 522125 | TX | Y | Agencies | Nursing Care |
No ID Information.