Healthcare Provider Details

I. General information

NPI: 1235196148
Provider Name (Legal Business Name): TROY T COLEMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/26/2006
Last Update Date: 03/10/2025
Certification Date: 03/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 W FRANK AVE
LUFKIN TX
75904-3357
US

IV. Provider business mailing address

PO BOX 3488
TUPELO MS
38803-3488
US

V. Phone/Fax

Practice location:
  • Phone: 936-634-8111
  • Fax:
Mailing address:
  • Phone: 479-452-9416
  • Fax: 479-242-1990

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number44917
License Number StateOK
# 2
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberMD2025-0124
License Number StateNM
# 3
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberJ9864
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: