Provider Demographics
NPI:1265453385
Name:CHARLES DOWNEY, MD, PA
Entity Type:Organization
Organization Name:CHARLES DOWNEY, MD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:RUSSELL
Authorized Official - Last Name:DOWNEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-231-9144
Mailing Address - Street 1:9101 LYNDON B JOHNSON FWY
Mailing Address - Street 2:SUITE 710
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75243-2057
Mailing Address - Country:US
Mailing Address - Phone:972-792-5700
Mailing Address - Fax:214-349-7707
Practice Address - Street 1:2821 E PRESIDENT GEORGE BUSH HWY
Practice Address - Street 2:SUITE 300
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75082-4266
Practice Address - Country:US
Practice Address - Phone:972-231-9144
Practice Address - Fax:972-231-9174
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-22
Last Update Date:2013-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1749954-01Medicaid
TXDC7476OtherMEDICARE RAILROAD
TX0056LTOtherBCBS
TX00331XMedicare ID - Type Unspecified