Individual
AMY G COBURN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
6560 FANNIN ST, SUITE 450, HOUSTON, TX 77030-2761
(713) 441-8843
Mailing address
6560 FANNIN ST, SUITE 450, HOUSTON, TX 77030-2761
(713) 441-8843
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
H6121
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0360550001
PALMETTO GBA
—
05
—
122802502
—
TX
05
—
122802505
—
TX
05
—
122802506
—
TX
05
—
122802507
—
TX
01
—
8CF306
BLUE CROSS BLUE SHIELD
TX
01
—
P00837098
MEDICARE RAILROAD
TX
01
—
P01063009
RAILROAD MEDICARE
TX
Enumeration date
04/20/2006
Last updated
08/30/2016
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