Individual provider Active NPI

Daniel Coronado, PA

  • Medical Physician Assistant
  • Houston, TX
National Provider Identifier
1801503198
Registry record updated Nov 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Practice address
2002 Holcombe Blvd.
Houston, TX 77030-4211
Phone
(713) 794-7375
NPI assigned
Nov 4, 2022
Last updated
Nov 4, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 4, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 363A00000X
Medical Physician Assistant 363AM0700X Primary

Addresses

Primary practice location

2002 Holcombe Blvd.
Houston, TX 77030-4211

Mailing address

2002 Holcomb Blvd
Geriatric Department VA Hospital
Houston, TX 77030-4211
Phone (713) 794-7375

Other practice location 1

91-1065 Meleikekai St
Ewa Beach, HI 96706-6557
Phone (808) 780-0601

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Physician Assistant

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1667520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667520000000",
    "number": "1801503198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2002 HOLCOMB BLVD",
            "address_2": "GERIATRIC DEPARTMENT VA HOSPITAL",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770304211",
            "telephone_number": "713-794-7375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2002 HOLCOMBE BLVD.",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770304211",
            "telephone_number": "713-794-7375"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "91-1065 Meleikekai St",
            "address_purpose": "LOCATION",
            "city": "Ewa Beach",
            "state": "HI",
            "postal_code": "967066557",
            "country_code": "US",
            "telephone_number": "808-780-0601",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CORONADO",
        "first_name": "DANIEL",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-11-04",
        "last_updated": "2022-11-04",
        "certification_date": "2022-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.