Provider Demographics
NPI:1093039539
Name:COKER, MELINDA FAYE (MD)
Entity type:Individual
Prefix:DR
First Name:MELINDA
Middle Name:FAYE
Last Name:COKER
Suffix:
Gender:
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:PO BOX 841656
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-1656
Mailing Address - Country:US
Mailing Address - Phone:903-531-5000
Mailing Address - Fax:
Practice Address - Street 1:910 E HOUSTON ST STE 650
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75702
Practice Address - Country:US
Practice Address - Phone:903-606-5300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-25
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME1296562085R0202X
LA3101842085R0202X
TXQ71662085R0202X
OH35.1276522085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX391721301Medicaid
TX8KE911OtherBCBS
TXP02137012OtherMEDICARE RAIL ROAD
TXP02137077OtherMEDICARE RAIL ROAD
TX729399OtherMEDICARE
TX391721302Medicaid
TX8KE921OtherBCBS
TX729329OtherMEDICARE