Provider Demographics
NPI:1093406613
Name:COKER, MILINDA LYNN (NACMA)
Entity Type:Individual
Prefix:MRS
First Name:MILINDA
Middle Name:LYNN
Last Name:COKER
Suffix:
Gender:F
Credentials:NACMA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6714 LAWSON CIR
Mailing Address - Street 2:
Mailing Address - City:TEXARKANA
Mailing Address - State:TX
Mailing Address - Zip Code:75503-6801
Mailing Address - Country:US
Mailing Address - Phone:903-556-9317
Mailing Address - Fax:
Practice Address - Street 1:6714 LAWSON CIR
Practice Address - Street 2:
Practice Address - City:TEXARKANA
Practice Address - State:TX
Practice Address - Zip Code:75503-6801
Practice Address - Country:US
Practice Address - Phone:903-559-7836
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-16
Last Update Date:2023-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1025431261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care