William Cooper, PA-C
Physician Assistant in Bryan, TX. Individual provider (NPI-1).
NPI number1659702504
StatusActive
Last updated in NPPESJan 3, 2014
Details
- NPI
- 1659702504
- Entity type
- Individual (NPI-1)
- Name
- William Cooper
- Credential
- PA-C
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Dec 3, 2013
- Last updated
- Jan 3, 2014
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | 102775 | NC | Yes |
| 363A00000X | Physician Assistant | PA04093 | TX |
Practice location
1100 Ursuline AveBryan, TX 77803-4951
Phone 979-823-1879
Mailing address
1100 Ursuline AveBryan, TX 77803-4951
Phone 979-823-1879
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