Basic Information
| Provider Information | |||||||||
| NPI: | 1760628184 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | TEXAS SCOTTISH RITE HOSPITAL FOR CRIPPLED CHILDREN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2222 WELBORN ST | ||||||||
| Address2: | |||||||||
| City: | DALLAS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 752193924 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2145595000 | ||||||||
| FaxNumber: | 2145598458 | ||||||||
| Practice Location | |||||||||
| Address1: | 2222 WELBORN ST | ||||||||
| Address2: | |||||||||
| City: | DALLAS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 752193924 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2145595000 | ||||||||
| FaxNumber: | 2145598458 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/07/2009 | ||||||||
| LastUpdateDate: | 10/13/2011 | ||||||||
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| AuthorizedOfficialLastName: | DALTON | ||||||||
| AuthorizedOfficialFirstName: | LORI | ||||||||
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| AuthorizedOfficialTitleorPosition: | VICE PRESIDENT AND GENERAL COUNSEL | ||||||||
| AuthorizedOfficialTelephone: | 2145597641 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 284300000X | 54 | TX | Y | Hospitals | Special Hospital |
No ID Information.