Organization
COPPELL CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MANOHAR VAJJA MD (PHYSICIAN)
(972) 899-1911
Entity
Organization
Contact information
Practice address
651 N DENTON TAP RD STE 100, COPPELL, TX 75019-2010
(214) 886-8496
Mailing address
651 N DENTON TAP RD SUITE 100, COPPELL, TX 75019
(972) 899-1911
Taxonomy
Speciality
Code
Description
License number
State
173000000X
Legal Medicine
Primary
M7714
TX
Other
Enumeration date
12/12/2013
Last updated
04/28/2014
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