Provider Demographics
NPI:1881261881
Name:COFFMAN, KIMBERLY DIANE (MD, MPH)
Entity type:Individual
Prefix:DR
First Name:KIMBERLY
Middle Name:DIANE
Last Name:COFFMAN
Suffix:
Gender:F
Credentials:MD, MPH
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Mailing Address - Street 1:DIVISION OF EDUCATION, DEPT. OF RADIOLOGY
Mailing Address - Street 2:7703 FLOYD CURL DRIVE, MC 7816
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-3900
Mailing Address - Country:US
Mailing Address - Phone:210-567-6482
Mailing Address - Fax:210-567-5541
Practice Address - Street 1:4502 MEDICAL DR
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-4402
Practice Address - Country:US
Practice Address - Phone:210-567-6482
Practice Address - Fax:210-567-5541
Is Sole Proprietor?:No
Enumeration Date:2021-06-08
Last Update Date:2022-06-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXBP100769862085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology