Provider Demographics
NPI:1902839707
Name:TENET HEALTHSYSTEM HOSPITALS DALLAS, INC.
Entity Type:Organization
Organization Name:TENET HEALTHSYSTEM HOSPITALS DALLAS, INC.
Other - Org Name:TRINITY MEDICAL CENTER
Other - Org Type:Doing Business As
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:2006-07-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX000042282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
80671OtherCOVENTRY HEALTH CARE IOWA
000437OtherHUMANA
31980OtherCOVENTRY HEALTH CARE KANS
450730B000000OtherSECTION 1011
HH0780OtherBCBS OF TEXAS
80671OtherCOVENTRY HEALTH CARE IOWA