Healthcare Provider Details

I. General information

NPI: 1245694629
Provider Name (Legal Business Name): CATHRYN COLEMAN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/11/2016
Last Update Date: 06/01/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4716 ALLIANCE BLVD STE 218
PLANO TX
75093-5373
US

IV. Provider business mailing address

800 8TH AVE STE 306
FORT WORTH TX
76104-2602
US

V. Phone/Fax

Practice location:
  • Phone: 469-800-5240
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberT0755
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: