Provider Demographics
NPI:1710009113
Name:JEAN F. CORIA, M.D., P.A.
Entity Type:Organization
Organization Name:JEAN F. CORIA, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JEAN
Authorized Official - Middle Name:F
Authorized Official - Last Name:CORIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:817-999-5134
Mailing Address - Street 1:2300 CASTLE ROCK RD
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76006-2712
Mailing Address - Country:US
Mailing Address - Phone:817-999-5134
Mailing Address - Fax:817-633-1504
Practice Address - Street 1:2300 CASTLE ROCK RD
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76006-2712
Practice Address - Country:US
Practice Address - Phone:817-633-2926
Practice Address - Fax:817-633-1504
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-04
Last Update Date:2011-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX815098032083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational MedicineGroup - Single Specialty