Provider Demographics
NPI:1598724593
Name:COCO, CLAIRE M (MD)
Entity Type:Individual
Prefix:
First Name:CLAIRE
Middle Name:M
Last Name:COCO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1260 RIVER ACRES DR
Mailing Address - Street 2:
Mailing Address - City:NEW BRAUNFELS
Mailing Address - State:TX
Mailing Address - Zip Code:78130-3689
Mailing Address - Country:US
Mailing Address - Phone:830-608-8084
Mailing Address - Fax:877-840-7258
Practice Address - Street 1:1260 RIVER ACRES DR
Practice Address - Street 2:
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78130-3689
Practice Address - Country:US
Practice Address - Phone:830-608-8084
Practice Address - Fax:877-840-7258
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-20
Last Update Date:2016-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL1547207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1115215Medicaid
LA1115215Medicaid
LA4E017Medicare ID - Type Unspecified