Individual provider · NPI-1

Andrea C Cooley, D.O.

Thoracic Surgery (Cardiothoracic Vascular Surgery) · Tyler, TX

NPI number1003070483
StatusActive
Last updated in NPPESMar 12, 2020

Details

NPI
1003070483
Entity type
Individual (NPI-1)
Name
Andrea C Cooley
Credential
D.O.
Sex
Female
Sole proprietor
No
Enumeration date
Jul 15, 2008
Certification date
Mar 12, 2020
Last updated
Mar 12, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery)P9320TXYes

Practice location

700 Olympic Plaza Cir Ste 508
Tyler, TX 75701-1952

Phone 903-595-6680 · Fax 903-592-1934

Mailing address

Po Box 130549
Tyler, TX 75713-0549

Phone 903-579-3931 · Fax 903-509-5835

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