Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | H9053 | TX |
N | 208600000X | Surgeon | H9053 | TX |
Y | 2082S0105X | Plastic Hand Surgeon | H9053 | TX |
NPI | 1629181680 |
---|---|
Provider Name | Woodward L Coleman |
First Address | San Antonio, TX 78217-5405 |
Second Address | San Antonio, TX 78217-5405 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/08/2006 |
Last Update Date | 05/03/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
126495403 | (05) | TX |
400000579 | MEDICARE RAILROAD (01) | TX |
D51414 | (02) | TX |