Brian Paul Coffee
Individual provider Active NPI Pharmacist · San Antonio, TX
NPI 1336749068 · NPPES record last updated Oct 30, 2020
Key facts
- NPI
- 1336749068
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 58426 (TX)
- Practice address
- 4331 Thousand Oaks Dr
San Antonio, TX 78217-2101 - Phone
- (210) 591-4979
- Fax
- (210) 591-4980
- NPI assigned
- Oct 30, 2020
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 58426 | TX | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 58426 | TX | Yes |
Addresses
Primary practice location
4331 Thousand Oaks Dr
San Antonio, TX 78217-2101
Mailing address
4331 Thousand Oaks Dr
San Antonio, TX 78217-2101
Phone (210) 591-4979
Other providers in San Antonio, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 30, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.