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Organization
DOUGLAS AVENUE MEDICAL MANAGEMENT CO
Active
Organization
DOUGLAS AVENUE MEDICAL MANAGEMENT CO
Active
Other names
Rocha General MEdicine Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ALBERTO RICARDO ROCHA (VP OPERATIONS)
(214) 522-3930
Entity
Organization
Contact information
Practice address
3330 DOUGLAS AVE, DALLAS, TX 75219-2717
(214) 522-3930
Mailing address
3330 DOUGLAS AVE, DALLAS, TX 75219-2717
(214) 522-3930
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
D3385
NULL
208D00000X
General Practice Physician
Primary
D3385
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00224W
MEDICARE GROUP #
TX
Enumeration date
10/09/2007
Last updated
10/09/2007
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