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Individual

DR. TOMAS CORONADO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
730 N MAIN, SUITE 719, SAN ANTONIO, TX 78205-1152
(210) 271-0818
Mailing address
730 N MAIN, SUITE 719, SAN ANTONIO, TX 78205-1152
(210) 271-0818

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
F6541
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000QL64
BLUE CROSS/BLUE SHIELD
TX
05
120097402
TX
01
17424475170001
STATE OF TEXAS
TX
01
4059998
AETNA
01
742447517
TRICARE
Enumeration date
06/17/2006
Last updated
06/03/2014
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