Provider Demographics
NPI:1376703934
Name:NDIMA, ERICA COCO
Entity Type:Individual
Prefix:MRS
First Name:ERICA
Middle Name:COCO
Last Name:NDIMA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4205 SNOWBIRD DR
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78413-4402
Mailing Address - Country:US
Mailing Address - Phone:361-549-2954
Mailing Address - Fax:361-850-7975
Practice Address - Street 1:4205 SNOWBIRD DR
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78413-4402
Practice Address - Country:US
Practice Address - Phone:361-549-2954
Practice Address - Fax:361-850-7975
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-16
Last Update Date:2008-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health