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NPI Code Detail

MEDICARE: DR. MARCO COPPOLA D.O.

MEDICARE: DR. MARCO COPPOLA D.O.
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
1207P00000XEmergency Medicine PhysicianK1801TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
28V2872OTHERTXBCBS
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4P00235950OTHERTXRAILROAD
5MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
78F6638OTHERTXBCBS
8MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1205811254
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MARCO COPPOLA D.O.
Provider Business Mailing Address
First Line : PO BOX 201606
Second Line :
City : DALLAS
State : TX
Zip : 75320-1606
Country : US
Telephone Number : 972-758-3598
Fax Number :
Provider Business Practice Location Address
First Line : 6800 N MACARTHUR BLVD
Second Line :
City : IRVING
State : TX
Zip : 75039-2422
Country : US
Telephone Number : 972-758-3598
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/13/2005
Last Update Date : 05/12/2010

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Directions to “ DR. MARCO COPPOLA D.O.” Practice Location

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