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General NPI Number Information
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NPI Number | 1548645377
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Entity Type | Organization
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Legal Business Name | BECKY COATS, DDS, PA
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Dates
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Enumeration Date | 07/22/2015
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Last Update Date | 07/22/2015
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Provider Practice Location Address
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Address Line | 2631 IRA E WOODS AVE
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City | GRAPEVINE
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State | TX
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Zip | 76051-3829
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Country | US
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Telephone | 817-481-6888
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Fax | 817-251-1999
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Provider Business Mailing Address
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Address Line | 2631 IRA E WOODS AVE
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City | GRAPEVINE
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State | TX
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Zip | 76051-3829
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Country | US
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Telephone | 817-481-6888
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Fax | 817-251-1999
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Authorized Official
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Title or Position | OWNER / DENTIST
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Name | DR. BECKY COATS
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Credential | DDS, PA
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Telephone | 817-481-6888
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 20165
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License Number State | TX
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