Provider Demographics
NPI:1659373744
Name:KOCAY, DEAN ALPHONSE (MD)
Entity Type:Individual
Prefix:DR
First Name:DEAN
Middle Name:ALPHONSE
Last Name:KOCAY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 DACY LN
Mailing Address - Street 2:SUITE 240
Mailing Address - City:KYLE
Mailing Address - State:TX
Mailing Address - Zip Code:78640-4964
Mailing Address - Country:US
Mailing Address - Phone:512-912-0480
Mailing Address - Fax:512-912-0408
Practice Address - Street 1:1300 DACY LN
Practice Address - Street 2:SUITE 240
Practice Address - City:KYLE
Practice Address - State:TX
Practice Address - Zip Code:78640-4964
Practice Address - Country:US
Practice Address - Phone:512-912-0480
Practice Address - Fax:512-912-0408
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-02
Last Update Date:2017-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF4173174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXC17986Medicare UPIN
TX506177Medicare PIN