Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080N0001X | Neonatal-Perinatal Doctor | G6652 | TX |
NPI | 1023139961 |
---|---|
Provider Name | Dr. Timothy Cooper |
First Address | Austin, TX 78733-5730 |
Second Address | Houston, TX 77077-1764 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/04/2007 |
Last Update Date | 08/07/2007 |