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Organization

M COLEMAN DRIVER JR MD PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
BRYAN N ANGLE MD (PHYSICIAN/OWNER)
(325) 942-9300
Entity
Organization

Contact information

Practice address
303 W. HARRIS AVE., SUITE 3, SAN ANGELO, TX 76903-6377
(325) 942-9300
(325) 942-9333
Mailing address
303 W. HARRIS AVE., SUITE 3, SAN ANGELO, TX 76903-6377
(325) 942-9300
(325) 942-9333

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
E7897
TX
207W00000X
Ophthalmology Physician
Primary
J1844
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
181813001
TX
Enumeration date
06/26/2006
Last updated
01/06/2012
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