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NPI Code Detail

MEDICARE: CLINICA AMERICA, P.A.

MEDICARE: CLINICA AMERICA, P.A.
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
1207Q00000XFamily Medicine Physician

General Provider Information

NPI Number : 1518294743
Entity Type Code : Organization
Provider Name (Legal Business Name) : CLINICA AMERICA, P.A.
Provider Business Mailing Address
First Line : 1515 N COCKRELL HILL RD
Second Line : SUITE 113
City : DALLAS
State : TX
Zip : 75211-1315
Country : US
Telephone Number : 214-339-9090
Fax Number : 214-339-9023
Provider Business Practice Location Address
First Line : 1515 N COCKRELL HILL RD
Second Line : SUITE 113
City : DALLAS
State : TX
Zip : 75211-1315
Country : US
Telephone Number : 214-339-9090
Fax Number : 214-339-9023
Authorized Official
Title or Position : DIRECTOR
Name : DR. PAUL L DEVANESON
Credential : M.D.
Telephone Number : 214-339-9090
Provider Enumeration Date : 11/09/2009
Last Update Date : 02/03/2010

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Directions to “CLINICA AMERICA, P.A. ” Practice Location

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