Individual
HOLLY E COKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
3614 CAMP BOWIE BLVD, FORT WORTH, TX 76107-3352
(866) 389-2727
Mailing address
PO BOX 99335, FORT WORTH, TX 76199-0335
(817) 920-6400
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA04513
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
183514201
—
TX
05
—
183514202
—
TX
05
—
183514204
—
TX
01
—
814N37
BCBS
TX
01
—
8371NC
BCBS
TX
01
—
P01142303
RAILROAD MEDICARE
TX
Enumeration date
09/29/2006
Last updated
03/01/2017
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