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General NPI Number Information
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NPI Number | 1649557984
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Entity Type | Organization
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Legal Business Name | MARK E. COIRA, P.C.
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Dates
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Enumeration Date | 11/15/2011
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Last Update Date | 02/28/2012
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Provider Practice Location Address
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Address Line | 8014 KITTY HAWK
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City | CONVERSE
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State | TX
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Zip | 78109-2424
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Country | US
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Telephone | 210-658-6000
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Fax | 210-658-6843
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Provider Business Mailing Address
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Address Line | 8014 KITTY HAWK
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City | CONVERSE
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State | TX
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Zip | 78109-2424
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Country | US
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Telephone | 210-658-6000
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Fax | 210-658-6843
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Authorized Official
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Title or Position | OWNER
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Name | DR. MARK EMIL COIRA
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Credential | D.C.
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Telephone | 210-658-6000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | 4216
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License Number State | TX
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