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COOPER CLINIC PA NPI 1588686547


NPI Information

NPI: 1588686547
Provider Name: COOPER CLINIC PA
Classification: Preventive Medicine - 2083P0901X
Entity Type: Organization

Specialization: Public Health & General Preventive Medicine

CLIA Number: 45D0480329

Address:
12200 PRESTON RD
DALLAS, TX
ZIP 75230
Phone: (972) 560-2667
Get Directions

COOPER CLINIC PA is a public health and general preventive medicine preventive medicine in Dallas, TX. The provider is public health and general preventive medicine focuses on promoting health, preventing disease, and managing the health of communities and defined populations. These practitioners combine population-based public health skills with knowledge of primary, secondary, and tertiary prevention-oriented clinical practice in a wide variety of settings. COOPER CLINIC PA NPI is 1588686547. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

12200 PRESTON RD
DALLAS, TX
ZIP 75230-223
Phone: (972) 560-2667
Fax: (972) 239-6649

The provider's authorized official is Robert M Nelson .
The authorized official title is Administrator and has the following contact phone number (972) 560-2667.

The CLIA number assigned to this NPI record is 45D0480329 - community clinic with a certificate type of Certificate of Accreditation.

The enumeration date for this NPI number is 7/25/2006 and was last updated on 8/22/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
12083P0901XPreventive MedicinePublic Health & General Preventive MedicineYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
100L286OTHERTEXASBLUE CROSS BLUE SHIELD

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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