Provider Demographics
NPI:1497915060
Name:EDUARDO G. AND ASUNCION A. ACOSTA, M.D.S, P.A.
Entity Type:Organization
Organization Name:EDUARDO G. AND ASUNCION A. ACOSTA, M.D.S, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:EDUARDO
Authorized Official - Middle Name:G
Authorized Official - Last Name:ACOSTA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-783-0222
Mailing Address - Street 1:375 MUNICIPAL DR
Mailing Address - Street 2:SUITE 134
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75080-3559
Mailing Address - Country:US
Mailing Address - Phone:972-783-0222
Mailing Address - Fax:972-783-1303
Practice Address - Street 1:375 MUNICIPAL DR
Practice Address - Street 2:SUITE 134
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080-3559
Practice Address - Country:US
Practice Address - Phone:972-783-0222
Practice Address - Fax:972-783-1303
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-16
Last Update Date:2014-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE7358207R00000X
TXE7345208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty