Healthcare Provider Details

I. General information

NPI: 1356523823
Provider Name (Legal Business Name): DCOA PHYSICIAN ASSOCIATES PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/27/2007
Last Update Date: 12/18/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17937 I-45 STE. 115
SHENANDOAH TX
77385-8708
US

IV. Provider business mailing address

13100 NORTHWEST FREEWAY STE 400
HOUSTON TX
77040-6346
US

V. Phone/Fax

Practice location:
  • Phone: 713-840-5280
  • Fax: 936-271-2690
Mailing address:
  • Phone: 832-237-3500
  • Fax: 281-897-9906

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. PHILIP C DOWLING
Title or Position: CEO
Credential:
Phone: 832-237-3500