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NPI Code Detail

MEDICARE: DR. C. EDWARD COFFEY M.D.

MEDICARE: DR. C. EDWARD COFFEY 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
12084P0800XPsychiatry PhysicianQ5783TX
22084N0400XNeurology PhysicianQ5783TX

General Provider Information

NPI Number : 1942360813
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. C. EDWARD COFFEY M.D.
Provider Business Mailing Address
First Line : 12301 MAIN ST
Second Line :
City : HOUSTON
State : TX
Zip : 77035-6207
Country : US
Telephone Number : 713-275-5007
Fax Number :
Provider Business Practice Location Address
First Line : 12301 MAIN ST
Second Line :
City : HOUSTON
State : TX
Zip : 77035-6207
Country : US
Telephone Number : 713-275-5007
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/11/2006
Last Update Date : 08/22/2016

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