Individual
DR. MARCO COPPOLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
6800 N MACARTHUR BLVD, IRVING, TX 75039-2422
(972) 758-3598
Mailing address
PO BOX 201606, DALLAS, TX 75320-1606
(972) 758-3598
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
K1801
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
037149401
—
TX
05
—
037149402
—
TX
05
—
037149403
—
TX
05
—
037149405
—
TX
05
—
13508067
—
NM
01
—
8F6638
BCBS
TX
01
—
8V2872
BCBS
TX
01
—
P00235950
RAILROAD
TX
Enumeration date
12/13/2005
Last updated
05/12/2010
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