Provider Demographics
NPI:1154340628
Name:CORONADO, ELIZABETH NEUGART (MD)
Entity type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:NEUGART
Last Name:CORONADO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3809 W 15TH ST
Mailing Address - Street 2:BLDG 700, SUITE A
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75075-1601
Mailing Address - Country:US
Mailing Address - Phone:972-379-2416
Mailing Address - Fax:972-867-1018
Practice Address - Street 1:3809 W 15TH ST
Practice Address - Street 2:BLDG 700, SUITE A
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75075-1601
Practice Address - Country:US
Practice Address - Phone:972-379-2416
Practice Address - Fax:972-867-1018
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM4743207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ943177Medicaid
TX8J3718OtherMEDICARE
AZBC9168976OtherDEA
AZI32350Medicare UPIN
103766Medicare ID - Type Unspecified