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General NPI Number Information
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NPI Number | 1649362641
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Entity Type | Individual
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Provider Name | JOHN LOUIS COSCIA JR. M.D.
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Gender | Male
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Dates
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Enumeration Date | 09/28/2006
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Last Update Date | 11/19/2013
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Provider Practice Location Address
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Address Line | 1000 S COULTER ST SUITE 100
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City | AMARILLO
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State | TX
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Zip | 79106-1781
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Country | US
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Telephone | 806-358-8654
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Fax | 806-356-8687
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Provider Business Mailing Address
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Address Line | PO BOX 911230
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City | DALLAS
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State | TX
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Zip | 75391-1230
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Country | US
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Telephone | 972-997-8000
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Fax | 972-234-0813
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | E3886
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number | E3886
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | E3886
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License Number State | TX
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