| E. Carlyle Smith, Jr. Health Center | |
|
801 Conover Dr Grand Prairie TX 75051-1519 | |
| (214) 266-3400 | |
| Not Available |
| Full Name | E. Carlyle Smith, Jr. Health Center |
|---|---|
| Speciality | Internal Medicine |
| Location | 801 Conover Dr, Grand Prairie, Texas |
| Authorized Official Name and Position | Frederick Cerise (PRESIDENT AND CEO) |
| Authorized Official Contact | 2145908006 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| E. Carlyle Smith, Jr. Health Center Po Box 660599 Dallas TX 75266-0599 Ph: () - | E. Carlyle Smith, Jr. Health Center 801 Conover Dr Grand Prairie TX 75051-1519 Ph: (214) 266-3400 |
| NPI Number | 1194090001 |
|---|---|
| Provider Enumeration Date | 03/12/2012 |
| Last Update Date | 12/19/2022 |
| Certification Date | 12/19/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194090001 | NPI | - | NPPES |
| 304256601 | Medicaid | TX | |
| 304256602 | Medicaid | TX |
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