Provider Demographics
NPI:1386520443
Name:DEKOCH, EMILY ELAINE (EP)
Entity type:Individual
Prefix:MRS
First Name:EMILY
Middle Name:ELAINE
Last Name:DEKOCH
Suffix:
Gender:F
Credentials:EP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:728 LASSO LOOP
Mailing Address - Street 2:
Mailing Address - City:CANYON LAKE
Mailing Address - State:TX
Mailing Address - Zip Code:78133-1950
Mailing Address - Country:US
Mailing Address - Phone:254-979-2253
Mailing Address - Fax:
Practice Address - Street 1:728 LASSO LOOP
Practice Address - Street 2:
Practice Address - City:CANYON LAKE
Practice Address - State:TX
Practice Address - Zip Code:78133-1950
Practice Address - Country:US
Practice Address - Phone:254-979-2253
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-14
Last Update Date:2025-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator