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General NPI Number Information
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NPI Number | 1164952693
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Entity Type | Individual
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Provider Name | CHRISTOPHER JAMES CORONEOS MD MSC FRCSC
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Gender | Male
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Dates
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Enumeration Date | 06/18/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 1515 HOLOCOMBE BLVD. THE UNIVERSITY OF TEXAS MD ANDERSO
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City | HOUSTON
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State | TX
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Zip | 77502
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Country | US
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Telephone | 713-794-1247
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Fax | 713-794-5492
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Provider Business Mailing Address
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Address Line | 1400 PRESSLER ST. THE UNIVERSITY OF TEXAS MD ANDERSON C DEPARTMENT OF PLASTIC SURGERY - UNIT 1488
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City | HOUSTON
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State | TX
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Zip | 77030
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Country | US
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Telephone | 713-794-1247
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Fax | 713-794-5492
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | BP10058863
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License Number State | TX
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