Healthcare Provider Details

I. General information

NPI: 1962877696
Provider Name (Legal Business Name): DCOA PHYSICIAN ASSOCIATES, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/07/2015
Last Update Date: 12/07/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7355 BARLITE BLVD SUITE #402
SAN ANTONIO TX
78224
US

IV. Provider business mailing address

13100 NORTHWEST FREEWAY SUITE #400
HOUSTON TX
77040
US

V. Phone/Fax

Practice location:
  • Phone: 210-858-9171
  • Fax: 844-788-2897
Mailing address:
  • Phone: 832-237-3500
  • Fax: 281-897-9906

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberN9748
License Number StateTX

VIII. Authorized Official

Name: MR. CHUCK DOWLING
Title or Position: CEO
Credential:
Phone: 713-840-5333