Provider Demographics
NPI:1902237431
Name:PROMISE HOSPITAL OF DALLAS INC.
Entity Type:Organization
Organization Name:PROMISE HOSPITAL OF DALLAS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:HOPWOOD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-869-3100
Mailing Address - Street 1:999 YAMATO RD
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33431-4477
Mailing Address - Country:US
Mailing Address - Phone:561-869-3100
Mailing Address - Fax:561-826-0171
Practice Address - Street 1:7955 HARRY HINES BLVD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75235-3305
Practice Address - Country:US
Practice Address - Phone:214-637-0000
Practice Address - Fax:214-637-6512
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PROMISE HEALTHCARE #2, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-12-10
Last Update Date:2018-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282E00000XHospitalsLong Term Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
452067Medicare Oscar/Certification