Individual
GREG CORONADO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
1110 NORTH GREENVILLE AVENUE, ALLEN, TX 75002
(972) 396-0006
(972) 396-0004
Mailing address
1110 NORTH GREENVILLE AVENUE, ALLEN, TX 75002
(972) 396-0006
(972) 396-0004
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4789TG
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00417953
MEDICARE RAILROAD PTAN
TX
Enumeration date
08/30/2006
Last updated
09/19/2008
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