Provider Demographics
NPI:1649557984
Name:MARK E. COIRA, P.C.
Entity Type:Organization
Organization Name:MARK E. COIRA, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:EMIL
Authorized Official - Last Name:COIRA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:210-658-6000
Mailing Address - Street 1:8014 KITTY HAWK
Mailing Address - Street 2:
Mailing Address - City:CONVERSE
Mailing Address - State:TX
Mailing Address - Zip Code:78109-2424
Mailing Address - Country:US
Mailing Address - Phone:210-658-6000
Mailing Address - Fax:210-658-6843
Practice Address - Street 1:8014 KITTY HAWK
Practice Address - Street 2:
Practice Address - City:CONVERSE
Practice Address - State:TX
Practice Address - Zip Code:78109-2424
Practice Address - Country:US
Practice Address - Phone:210-658-6000
Practice Address - Fax:210-658-6843
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-15
Last Update Date:2012-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4216261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty