| |
6356 Phelan Blvd, Beaumont, TX 77706-6150 | |
(409) 347-8606 | |
(409) 420-3086 |
Full Name | |
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Type | Facility |
Speciality | Physical Medicine & Rehabilitation |
Location | 6356 Phelan Blvd, Beaumont, Texas |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1093242125 | NPI | - | NPPES |
587017 | Other | TX | MEDICARE |
Provider Name | Tiffany A Coronado |
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Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1366763187 PECOS PAC ID: 7315218419 Enrollment ID: I20170808003262 |
Mailing Address | Practice Location Address |
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6356 Phelan Blvd, Beaumont, TX 77706-6150 Ph: (409) 347-8606 | 6356 Phelan Blvd, Beaumont, TX 77706-6150 Ph: (409) 347-8606 |