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NPI Code Detail

MEDICARE: CYNARA L COOMER M.D.

MEDICARE: CYNARA L COOMER 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
1174400000XSpecialist236455NY
2208600000XSurgery PhysicianT5855TX
32086X0206XSurgical Oncology PhysicianT5855TX

Other Identifiers

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

General Provider Information

NPI Number : 1437105392
Entity Type Code : Individual
Provider Name (Legal Business Name) : CYNARA L COOMER M.D.
Provider Business Mailing Address
First Line : 1300 W TERRELL AVE STE 420
Second Line :
City : FORT WORTH
State : TX
Zip : 76104-2810
Country : US
Telephone Number : 817-250-6570
Fax Number :
Provider Business Practice Location Address
First Line : 1300 W TERRELL AVE STE 420
Second Line :
City : FORT WORTH
State : TX
Zip : 76104-2810
Country : US
Telephone Number : 817-250-6570
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/25/2006
Last Update Date : 05/04/2022

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Directions to “ CYNARA L COOMER M.D.” Practice Location

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