Provider Demographics
NPI:1114938826
Name:COLEMAN, ANNE G (MD)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:G
Last Name:COLEMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:375 MUNICIPAL DR
Mailing Address - Street 2:STE. 128
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75080-3559
Mailing Address - Country:US
Mailing Address - Phone:972-669-4111
Mailing Address - Fax:972-669-1418
Practice Address - Street 1:375 MUNICIPAL DR
Practice Address - Street 2:STE. 128
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080-3559
Practice Address - Country:US
Practice Address - Phone:972-669-4111
Practice Address - Fax:972-669-1418
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-10
Last Update Date:2008-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH7969207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXF35956Medicare UPIN
TX00067MMedicare PIN