Provider Demographics
NPI:1659715274
Name:COON, JOHN ISAAC (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:ISAAC
Last Name:COON
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 1:301 UNIVERSITY BLVD
Mailing Address - Street 2:
Mailing Address - City:GALVESTON
Mailing Address - State:TX
Mailing Address - Zip Code:77555-0526
Mailing Address - Country:US
Mailing Address - Phone:409-772-6679
Mailing Address - Fax:409-772-0744
Practice Address - Street 1:301 UNIVERSITY BLVD
Practice Address - Street 2:
Practice Address - City:GALVESTON
Practice Address - State:TX
Practice Address - Zip Code:77555-0526
Practice Address - Country:US
Practice Address - Phone:409-772-6679
Practice Address - Fax:409-772-0744
Is Sole Proprietor?:No
Enumeration Date:2013-04-25
Last Update Date:2024-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ9321208000000X, 2080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics