Organization
BERNICE COLEMAN
Active
Other names
Bernice Coleman
Organization subpart
No
Provider details
NPI number
Authorized official
BERNICE COLEMAN (OWNER)
(972) 880-7217
Entity
Organization
Contact information
Practice address
405 ISAAC CIR APT D, WYLIE, TX 75098-9036
(972) 880-7217
Mailing address
405 ISAAC CIR APT D, WYLIE, TX 75098-9036
(972) 880-7217
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
—
—
347C00000X
Private Vehicle
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
33676977
DRIVER LICENSE
AR
Enumeration date
05/04/2022
Last updated
06/30/2022
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