Samuel Coleridge

NPI #1013986058 in Fort Worth, Texas

Provider Information

NPI Number: 1013986058
Entity Type: Individual
Name: Samuel Coleridge
Gender: Not Specified
Sole Proprietor: Not Answered
Primary Specialty: Family Medicine
Enumeration Date: Mar 14, 2006
Last Updated: Jul 8, 2007

Practice Location

Address: 2106 N MAIN ST
City: Fort Worth
State: Texas
ZIP Code: 76106-8511
Phone: (817) 625-4254

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Family Medicine	207Q00000X	Primary

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