Provider Demographics
NPI:1326375676
Name:COKER, DANA L (PA)
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:L
Last Name:COKER
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:DANA
Other - Middle Name:COKER
Other - Last Name:KINGDON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:311 N ALLEN DR
Mailing Address - Street 2:
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75013-2539
Mailing Address - Country:US
Mailing Address - Phone:972-727-8000
Mailing Address - Fax:972-727-0842
Practice Address - Street 1:311 N ALLEN DR
Practice Address - Street 2:
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75013-2539
Practice Address - Country:US
Practice Address - Phone:972-727-8000
Practice Address - Fax:972-727-0842
Is Sole Proprietor?:No
Enumeration Date:2009-11-06
Last Update Date:2014-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA01448363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX208562301Medicaid
TX8L22176Medicare PIN
TX279349YKP5Medicare PIN