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General NPI Number Information
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NPI Number | 1407269137
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Entity Type | Organization
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Legal Business Name | COLEMAN EYECARE PLLC
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Dates
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Enumeration Date | 06/10/2014
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Last Update Date | 02/04/2015
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Provider Practice Location Address
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Address Line | 15220 MONTFORT RD SUITE 1001
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City | DALLAS
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State | TX
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Zip | 75248-6401
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Country | US
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Telephone | 972-308-0022
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Fax | 972-233-9317
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Provider Business Mailing Address
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Address Line | 15220 MONTFORT RD SUITE 1001
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City | DALLAS
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State | TX
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Zip | 75248-6401
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Country | US
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Telephone | 972-308-0022
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Fax | 972-233-9317
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | DR. JEFFREY RAY COLEMAN
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Credential | O.D.
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Telephone | 214-704-4702
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 7320TG
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License Number State | TX
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