Basic Information
| Provider Information | |||||||||
| NPI: | 1265453385 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CHARLES DOWNEY, MD, PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9101 LYNDON B JOHNSON FWY | ||||||||
| Address2: | SUITE 710 | ||||||||
| City: | DALLAS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 752432057 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9727925700 | ||||||||
| FaxNumber: | 2143497707 | ||||||||
| Practice Location | |||||||||
| Address1: | 2821 E PRESIDENT GEORGE BUSH HWY | ||||||||
| Address2: | SUITE 300 | ||||||||
| City: | RICHARDSON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 750824266 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9722319144 | ||||||||
| FaxNumber: | 9722319174 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/22/2006 | ||||||||
| LastUpdateDate: | 05/14/2013 | ||||||||
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| AuthorizedOfficialLastName: | DOWNEY | ||||||||
| AuthorizedOfficialFirstName: | CHARLES | ||||||||
| AuthorizedOfficialMiddleName: | RUSSELL | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 9722319144 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
ID Information
| ID | Type | State | Issuer | Description | 1749954-01 | 05 | TX | MEDICAID | DC7476 | 01 | TX | MEDICARE RAILROAD | OTHER | 0056LT | 01 | TX | BCBS | OTHER |