Organization
CORAL MEDICAL SERVICES, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES ORTEGA PA (ADMINISTRATOR)
(214) 244-6171
Entity
Organization
Contact information
Practice address
9102 GARLAND RD, SUITE 100, DALLAS, TX 75218-3901
(214) 244-6171
(972) 262-8311
Mailing address
9102 GARLAND RD, SUITE 100, DALLAS, TX 75218-3901
(214) 244-6171
(972) 262-8311
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
K5697
TX
207Q00000X
Family Medicine Physician
PA02353
TX
Other
Enumeration date
07/13/2010
Last updated
09/12/2016
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