Basic Information
| Provider Information | |||||||||
| NPI: | 1750448122 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | COLEMAN | ||||||||
| FirstName: | NANA | ||||||||
| MiddleName: | EKUA | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D., ED.M. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6621 FANNIN ST | ||||||||
| Address2: | SUITE W6-006 | ||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770302358 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8328266230 | ||||||||
| FaxNumber: | 8328256229 | ||||||||
| Practice Location | |||||||||
| Address1: | 6621 FANNIN ST | ||||||||
| Address2: | SUITE W6-006 | ||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770302358 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8328266230 | ||||||||
| FaxNumber: | 8328256229 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/03/2007 | ||||||||
| LastUpdateDate: | 06/05/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | P9318 | TX | Y | Allopathic & Osteopathic Physicians | Pediatrics | 2080P0203X | P9318 | TX | N | Allopathic & Osteopathic Physicians | Pediatrics | Pediatric Critical Care Medicine |
No ID Information.