Provider Demographics
NPI:1134720204
Name:CORONA, DAVID MARTIN (PHARMD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:MARTIN
Last Name:CORONA
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 WESTVIEW BLVD
Mailing Address - Street 2:
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77304-3596
Mailing Address - Country:US
Mailing Address - Phone:936-539-9429
Mailing Address - Fax:936-539-9379
Practice Address - Street 1:2000 WESTVIEW BLVD
Practice Address - Street 2:
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77304-3596
Practice Address - Country:US
Practice Address - Phone:936-539-9429
Practice Address - Fax:936-539-9379
Is Sole Proprietor?:No
Enumeration Date:2020-11-05
Last Update Date:2020-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX63651183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist