Coleman, Jessie Daniel Juan

Coleman, Jessie Daniel Juan is an individual health care provider with primary practice located at 3215 Gateway Blvd W , El Paso TX 79903-4225. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Anesthesiology, Allopathic & Osteopathic Physicians / Pain Medicine. Allopathic & Osteopathic Physicians / Pain Medicine is his primary health care specialty. Coleman, Jessie Daniel Juan can be contacted via phone (915) 598-7246.

Contact Information

Primary practice address
3215 Gateway Blvd W El Paso TX 79903-4225
Phone: (915) 598-7246
Fax: (915) 633-6598
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X 10844 Texas
Allopathic & Osteopathic Physicians / Pain Medicine 207LP2900X Q1377 Texas

Profile Details

NPI number 1174806277
LBN Legal business name Coleman, Jessie Daniel Juan
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 25th, 2011
Last updated Jul 21st, 2022 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1174806277 NPPES
Texas MEDICAID 346729204

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