Provider Demographics
NPI:1487050241
Name:CORALIE A.K. TEXEIRA, M.D. LLC
Entity type:Organization
Organization Name:CORALIE A.K. TEXEIRA, M.D. LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CORALIE
Authorized Official - Middle Name:ANN KANANI
Authorized Official - Last Name:TEXEIRA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:808-670-6458
Mailing Address - Street 1:92-1527 ALIINUI DR
Mailing Address - Street 2:STE C
Mailing Address - City:KAPOLEI
Mailing Address - State:HI
Mailing Address - Zip Code:96707-2232
Mailing Address - Country:US
Mailing Address - Phone:808-670-6458
Mailing Address - Fax:
Practice Address - Street 1:92-1527 ALIINUI DR
Practice Address - Street 2:STE C
Practice Address - City:KAPOLEI
Practice Address - State:HI
Practice Address - Zip Code:96707-2232
Practice Address - Country:US
Practice Address - Phone:808-670-6458
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-06
Last Update Date:2014-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI13563208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty