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
—
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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