Tara Latonya Cooper, OTHER
Durable Medical Equipment & Medical Supplies in Tyler, TX. Individual provider (NPI-1).
NPI number1245857580
StatusActive
Last updated in NPPESJul 13, 2021
Details
- NPI
- 1245857580
- Entity type
- Individual (NPI-1)
- Name
- Tara Latonya Cooper
- Credential
- OTHER
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Jul 2, 2020
- Certification date
- Jul 13, 2021
- Last updated
- Jul 13, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 332B00000X | Durable Medical Equipment & Medical Supplies | 32066800494 | TX | Yes |
| 247200000X | Technician, Other | – | – |
Practice location
1743 Troup HwyTyler, TX 75701-5869
Phone 903-363-6208
Mailing address
1743 Troup HwyTyler, TX 75701-5869
Phone 682-433-2979
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