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General NPI Number Information
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NPI Number | 1285906479
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Entity Type | Organization
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Legal Business Name | TOMAS CORONADO MD
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Dates
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Enumeration Date | 02/02/2012
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Last Update Date | 06/03/2014
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Provider Practice Location Address
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Address Line | 730 N MAIN AVE STE 719
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City | SAN ANTONIO
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State | TX
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Zip | 78205-1117
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Country | US
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Telephone | 210-271-0818
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Fax | 210-212-8807
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Provider Business Mailing Address
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Address Line | 730 N MAIN AVE STE 719
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City | SAN ANTONIO
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State | TX
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Zip | 78205-1117
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Country | US
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Telephone | 210-271-0818
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Fax | 210-212-8807
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Authorized Official
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Title or Position | SOLE PROPRIETOR
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Name | DR. TOMAS CORONADO
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Credential | M.D.
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Telephone | 210-271-0818
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QS0132X
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Taxonomy Name | Ophthalmologic Surgery Clinic/Center
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License Number | F6541
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License Number State | TX
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