Provider Demographics
NPI:1629181680
Name:COLEMAN, WOODWARD L (MD)
Entity Type:Individual
Prefix:
First Name:WOODWARD
Middle Name:L
Last Name:COLEMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8715 VILLAGE DR
Mailing Address - Street 2:SUITE 504
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78217-5405
Mailing Address - Country:US
Mailing Address - Phone:210-251-4362
Mailing Address - Fax:210-251-3383
Practice Address - Street 1:8715 VILLAGE DR
Practice Address - Street 2:SUITE 504
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78217-5405
Practice Address - Country:US
Practice Address - Phone:210-215-4362
Practice Address - Fax:210-251-3383
Is Sole Proprietor?:No
Enumeration Date:2006-08-16
Last Update Date:2020-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH90532082S0105X, 208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2082S0105XAllopathic & Osteopathic PhysiciansPlastic SurgerySurgery of the Hand
No208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX126495403Medicaid
TX400000579OtherMEDICARE RAILROAD
TXD51414Medicare UPIN
TX126495403Medicaid