Provider Demographics
NPI:1861530990
Name:CITY OF DALLAS
Entity type:Organization
Organization Name:CITY OF DALLAS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:RAJAN
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-671-8946
Mailing Address - Street 1:PO BOX 843835
Mailing Address - Street 2:1950 N STEMMONS FWY
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-3835
Mailing Address - Country:US
Mailing Address - Phone:888-729-1886
Mailing Address - Fax:888-974-1293
Practice Address - Street 1:1500 MARILLA ST
Practice Address - Street 2:SUITE 7AS
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75201-6318
Practice Address - Country:US
Practice Address - Phone:888-729-1886
Practice Address - Fax:888-974-1293
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-01
Last Update Date:2017-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0570163416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX503600OtherBLUE CROSS BLUE SHIELD
TX086411801Medicaid
TX590039793OtherRAILROAD MEDICARE
TX503600OtherBLUE CROSS BLUE SHIELD