Doctor Name: | MR. RICHARD COLEMAN |
NPI Number: | 1003153628 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | FNP-BC |
License Number: | 685397 |
Business Practice Address: | 128 N. Fm 3167 Rio Grande City, TX - 78582 |
Business Phone Number: | 9564870453 |
Business Fax Number: | 9564876190 |
Mailing Address: | 2112 W University Dr. 340, EDINBURG |
State: | TX |
Postal Code: | 78539 |
Phone Number: | 9568785409 |
Fax Number: | |
NPI Enumeration Date: | 01/16/2013 |
NPI Last Update Date: | 10/12/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 685397 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |