MEDICARE: ANABEL LOPEZ CORONADO MD PA

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	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1457474389
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANABEL LOPEZ CORONADO MD PA

Provider Business Mailing Address
First Line	:	2150 TRAWOOD DR
Second Line	:	A 100
City	:	EL PASO
State	:	TX
Zip	:	79935-3322
Country	:	US
Telephone Number	:	615-633-1124
Fax Number	:	915-633-1336

Provider Business Practice Location Address
First Line	:	2150 TRAWOOD DR
Second Line	:	A 100
City	:	EL PASO
State	:	TX
Zip	:	79935-3322
Country	:	US
Telephone Number	:	615-633-1124
Fax Number	:	915-633-1336

Authorized Official
Title or Position	:	MD PA
Name	:	ANABEL LOPEZ CORONADO
Credential	:
Telephone Number	:	915-633-1124

Provider Enumeration Date	:	04/07/2007
Last Update Date	:	09/05/2007

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