Provider Demographics
NPI:1518294743
Name:CLINICA AMERICA, P.A.
Entity Type:Organization
Organization Name:CLINICA AMERICA, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:L
Authorized Official - Last Name:DEVANESON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:214-339-9090
Mailing Address - Street 1:1515 N COCKRELL HILL RD
Mailing Address - Street 2:SUITE 113
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75211-1315
Mailing Address - Country:US
Mailing Address - Phone:214-339-9090
Mailing Address - Fax:214-339-9023
Practice Address - Street 1:1515 N COCKRELL HILL RD
Practice Address - Street 2:SUITE 113
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75211-1315
Practice Address - Country:US
Practice Address - Phone:214-339-9090
Practice Address - Fax:214-339-9023
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-09
Last Update Date:2010-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty