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General NPI Number Information
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NPI Number | 1619060233
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Entity Type | Organization
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Legal Business Name | COLEMAN MEDICAL ASSOCIATES PA
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Dates
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Enumeration Date | 10/02/2006
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Last Update Date | 09/14/2010
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Provider Practice Location Address
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Address Line | 310 S PECOS ST 2ND FLR
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City | COLEMAN
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State | TX
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Zip | 76834-4159
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Country | US
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Telephone | 325-625-3533
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Fax | 325-625-3477
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Provider Business Mailing Address
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Address Line | PO BOX 312
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City | COLEMAN
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State | TX
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Zip | 76834
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Country | US
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Telephone | 325-625-3533
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Fax | 325-625-3477
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Authorized Official
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Title or Position | PHYSICIAN OWNER
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Name | JARRELL PAUL REYNOLDS
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Credential | MD
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Telephone | 325-625-3533
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | H0755
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License Number State | TX
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