MEDICARE: DCOA PHYSICIAN ASSOCIATES PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RE0101X	Endocrinology, Diabetes & Metabolism Physician
2	261QM2500X	Medical Specialty Clinic/Center

General Provider Information

NPI Number	:	1023282746
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DCOA PHYSICIAN ASSOCIATES PA

Provider Business Mailing Address
First Line	:	13100 NORTHWEST FREEWAY
Second Line	:	STE 400
City	:	HOUSTON
State	:	TX
Zip	:	77040-6346
Country	:	US
Telephone Number	:	832-237-3500
Fax Number	:	281-897-9906

Provider Business Practice Location Address
First Line	:	7863 CALLAGHAN ROAD
Second Line	:	STE 206
City	:	SAN ANTONIO
State	:	TX
Zip	:	78229-2452
Country	:	US
Telephone Number	:	210-525-1206
Fax Number	:	210-525-0160

Authorized Official
Title or Position	:	CEO
Name	:	MR. PHILIP C DOWLING
Credential	:
Telephone Number	:	832-237-3500

Provider Enumeration Date	:	04/14/2008
Last Update Date	:	12/18/2013

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