Organization
KIMBERLY WILLS COATES M.D.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GRETCHEN M REYNA (BILLING MANAGER)
(512) 326-4300
Entity
Organization
Contact information
Practice address
511 OAKWOOD BLVD, SUITE 200, ROUND ROCK, TX 78681-4007
(512) 255-0769
Mailing address
511 OAKWOOD BLVD, SUITE 200, ROUND ROCK, TX 78681-4007
(512) 255-0769
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
J1937
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0064LP
BCBS INDIVIDUAL
TX
01
—
J1937
STATE LICENSE NUMBER
TX
Enumeration date
02/11/2008
Last updated
02/11/2008
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