Organization Name: | DALLAS INTER-TRIBAL CENTER |
NPI Number: | 1710108923 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | RODNEY STAPP (CEO) |
Mailing Address: | 1261 Record Crossing Rd Dallas |
State: | TX US |
Postal Code: | 752356001 |
Phone Number: | 2149411050 |
Fax Number: | 2149464738 |
NPI Enumeration Date: | 05/02/2007 |
NPI Last Update Date: | 06/11/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332800000X |
License Number: | 12584 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | TX |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy |
Taxonomy Specialization: | |
Taxonomy Definition: | An Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy means a pharmacy operated by the Indian Health Service, an Indian tribe or tribal organization, or an urban Indian organization, all of which are defined in Section 4 of the Indian Health Care Improvement Act, 25 U.S.C. 1603. |