Provider Demographics
NPI:1104047018
Name:DCOA PHYSICIAN ASSOCIATES, PA
Entity type:Organization
Organization Name:DCOA PHYSICIAN ASSOCIATES, PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:CHUCK
Authorized Official - Middle Name:
Authorized Official - Last Name:DOWLING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-840-5333
Mailing Address - Street 1:13100 NORTHWEST FREEWAY
Mailing Address - Street 2:SUITE # 400
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77040
Mailing Address - Country:US
Mailing Address - Phone:832-237-3500
Mailing Address - Fax:281-897-9906
Practice Address - Street 1:12266 FM 1960
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77065
Practice Address - Country:US
Practice Address - Phone:713-840-5110
Practice Address - Fax:287-469-9119
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DCOA PHYSICIAN ASSOCIATES, PA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-05-01
Last Update Date:2015-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
No207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty