Provider Demographics
NPI:1285906479
Name:TOMAS CORONADO MD
Entity type:Organization
Organization Name:TOMAS CORONADO MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPRIETOR
Authorized Official - Prefix:DR
Authorized Official - First Name:TOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:CORONADO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:210-271-0818
Mailing Address - Street 1:730 N MAIN AVE STE 719
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78205-1117
Mailing Address - Country:US
Mailing Address - Phone:210-271-0818
Mailing Address - Fax:210-212-8807
Practice Address - Street 1:730 N MAIN AVE STE 719
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78205-1117
Practice Address - Country:US
Practice Address - Phone:210-271-0818
Practice Address - Fax:210-212-8807
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-02
Last Update Date:2014-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF6541261QS0132X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS0132XAmbulatory Health Care FacilitiesClinic/CenterOphthalmologic Surgery