Provider Demographics
NPI:1093497604
Name:CORONA, EDUARDO DAVID
Entity type:Individual
Prefix:
First Name:EDUARDO
Middle Name:DAVID
Last Name:CORONA
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:709 E ESPERANZA AVE
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78501-1470
Mailing Address - Country:US
Mailing Address - Phone:956-413-7005
Mailing Address - Fax:956-277-9489
Practice Address - Street 1:5319 S MCCOLL RD
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539-9168
Practice Address - Country:US
Practice Address - Phone:956-595-5637
Practice Address - Fax:956-277-9489
Is Sole Proprietor?:No
Enumeration Date:2023-08-02
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1041C0700X
TX109870104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical