Individual
AIDA R. COFFEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1010 RANCH ROAD 620 SOUTH, SUITE 108, LAKEWAY, TX 78734
(512) 565-5003
(512) 263-9975
Mailing address
1010 RANCH ROAD 620 SOUTH, SUITE 108, LAKEWAY, TX 78734
(512) 565-5003
(512) 263-9975
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
G48976
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0068DB
BLUE CROSS
TX
05
—
030719101
—
TX
Enumeration date
11/14/2006
Last updated
10/27/2025
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