Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | 7320 | TX |
N | 152WC0802X | Optomitrist - Corneal and Contact Lenses | 7320 | TX |
N | 152WS0006X | Sports Vision | 7320 | TX |
NPI | 1104129162 |
---|---|
Provider Name | Dr. Jeffrey Ray Coleman |
First Address | Dallas, TX 75248 |
Second Address | Dallas, TX 75248-6401 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/12/2010 |
Last Update Date | 14/12/2010 |