NPIMap

Organization Active NPI

Douglas Avenue Medical Management Co

  • General Practice Physician
  • Dallas, TX
National Provider Identifier
1447448063
Registry record updated Oct 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
D3385
Legal business name
DOUGLAS AVENUE MEDICAL MANAGEMENT CO
Practice address
3330 Douglas Ave
Dallas, TX 75219-2717
Phone
(214) 522-3930
NPI assigned
Oct 9, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Alberto Ricardo Rocha
Title
VP Operations
Phone
(214) 522-3930

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208D00000X D3385 Primary

Addresses

Primary practice location

3330 Douglas Ave
Dallas, TX 75219-2717

Mailing address

3330 Douglas Ave
Dallas, TX 75219-2717
Phone (214) 522-3930

Other identifiers 1

IdentifierTypeStateIssuer
00224WOtherTXMEDICARE GROUP #

Other names 1

  • Rocha General MEdicine Clinic Doing business as

National Provider Directory

National Provider Directory

Locations

3330 Douglas Ave
Dallas, TX 75219
Phone (214) 522-3930

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1191888000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1191888000000",
    "number": "1447448063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3330 DOUGLAS AVE",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752192717",
            "telephone_number": "214-522-3930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3330 DOUGLAS AVE",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752192717",
            "telephone_number": "214-522-3930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOUGLAS AVENUE MEDICAL MANAGEMENT CO",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-09",
        "last_updated": "2007-10-09",
        "status": "A",
        "authorized_official_last_name": "ROCHA",
        "authorized_official_first_name": "ALBERTO",
        "authorized_official_middle_name": "RICARDO",
        "authorized_official_title_or_position": "VP OPERATIONS",
        "authorized_official_telephone_number": "214-522-3930",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": null,
            "license": "D3385",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP #",
            "identifier": "00224W",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rocha General MEdicine Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.