MEDICARE: MARIA DE LOURDES M. C. COIMBRA M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	N2446	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1316188725
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIA DE LOURDES M. C. COIMBRA M.D.

Provider Business Mailing Address
First Line	:	2108 S M ST STE 3
Second Line	:
City	:	MCALLEN
State	:	TX
Zip	:	78503-1556
Country	:	US
Telephone Number	:	956-992-0660
Fax Number	:	956-278-8128

Provider Business Practice Location Address
First Line	:	2108 S M ST STE 3
Second Line	:
City	:	MCALLEN
State	:	TX
Zip	:	78503-1556
Country	:	US
Telephone Number	:	956-992-0660
Fax Number	:	956-278-8128

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/13/2009
Last Update Date	:	11/17/2016

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