Individual
CYNARA L COOMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1300 W TERRELL AVE STE 420, FORT WORTH, TX 76104-2810
(817) 250-6570
Mailing address
1300 W TERRELL AVE STE 420, FORT WORTH, TX 76104-2810
(817) 250-6570
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
236455
NY
208600000X
Surgery Physician
T5855
TX
2086X0206X
Surgical Oncology Physician
Primary
T5855
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02677549
—
NY
Enumeration date
05/25/2006
Last updated
05/04/2022
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