Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | T0756 | TX |
NPI | 1003300427 |
---|---|
Provider Name | Claire Cooper |
First Address | Lubbock, TX 79430-0002 |
Second Address | Lubbock, TX 79403-5329 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/06/2018 |
Last Update Date | 04/10/2021 |