Provider Demographics
NPI:1376581686
Name:COLEMAN, PAUL H (MD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:H
Last Name:COLEMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 SCRIPTURE ST
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76201-3809
Mailing Address - Country:US
Mailing Address - Phone:940-384-6200
Mailing Address - Fax:940-382-7680
Practice Address - Street 1:520 E 6TH ST
Practice Address - Street 2:
Practice Address - City:ODESSA
Practice Address - State:TX
Practice Address - Zip Code:79761-4527
Practice Address - Country:US
Practice Address - Phone:432-582-8460
Practice Address - Fax:432-582-8939
Is Sole Proprietor?:No
Enumeration Date:2006-06-02
Last Update Date:2014-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH 5757207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX219137101Medicaid
B01397Medicare UPIN
TX219137101Medicaid
TN100025355OtherPHP TENNCARE
GA510068996BMedicaid
B01397Medicare UPIN
TN37822OtherTLC TENNCARE
AL009938127Medicaid
TN3338757Medicaid
TX219137101Medicaid
TX8L25989Medicare PIN
TN4129017OtherBLUE SHIELD
TN3338757Medicare ID - Type Unspecified