Provider Demographics
NPI:1225694979
Name:DUCHICELA & ASSOCIATES PA
Entity Type:Organization
Organization Name:DUCHICELA & ASSOCIATES PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:WHITNEY
Authorized Official - Middle Name:
Authorized Official - Last Name:BARRETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:979-725-8545
Mailing Address - Street 1:402 YOUENS DR
Mailing Address - Street 2:
Mailing Address - City:WEIMAR
Mailing Address - State:TX
Mailing Address - Zip Code:78962-3680
Mailing Address - Country:US
Mailing Address - Phone:979-725-8545
Mailing Address - Fax:
Practice Address - Street 1:402 YOUENS DR
Practice Address - Street 2:
Practice Address - City:WEIMAR
Practice Address - State:TX
Practice Address - Zip Code:78962-3680
Practice Address - Country:US
Practice Address - Phone:979-725-8545
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:YOUENS, DUCHICELA & ASSOCIATES, P.A.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-05-17
Last Update Date:2019-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX092508304Medicaid