MEDICARE: DR. JORGE CORONA M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207W00000X	Ophthalmology Physician	M5109	TX
2	207WX0200X	Ophthalmic Plastic and Reconstructive Surgery Physician	M5109	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1104816404
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JORGE CORONA M.D.

Provider Business Mailing Address
First Line	:	8230 WALNUT HILL LN
Second Line	:	SUITE 508
City	:	DALLAS
State	:	TX
Zip	:	75231-4482
Country	:	US
Telephone Number	:	214-369-0555
Fax Number	:	214-363-6759

Provider Business Practice Location Address
First Line	:	8230 WALNUT HILL LN
Second Line	:	SUITE 508
City	:	DALLAS
State	:	TX
Zip	:	75231-4482
Country	:	US
Telephone Number	:	214-369-0555
Fax Number	:	214-363-6759

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/27/2005
Last Update Date	:	11/27/2023

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Directions to “ DR. JORGE CORONA M.D.” Practice Location

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