1245327006 NPI number — MR. THOMAS EDWARD COOPER L.P.C.

Table of content: MR. THOMAS EDWARD COOPER L.P.C. (NPI 1245327006)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1245327006 NPI number — MR. THOMAS EDWARD COOPER L.P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
COOPER
Provider First Name:
THOMAS
Provider Middle Name:
EDWARD
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
L.P.C.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1245327006
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5495 N. LITTLE RIVER LN.
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TUCSON
Provider Business Mailing Address State Name:
AZ
Provider Business Mailing Address Postal Code:
85704-1770
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
520-256-5808
Provider Business Mailing Address Fax Number:
520-746-4143

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
110 S. CHURCH ST., STE. 207
Provider Second Line Business Practice Location Address:
CACTUS COUNSELING ASSOCIATES
Provider Business Practice Location Address City Name:
TUCSON
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85701-7632
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
520-798-3659
Provider Business Practice Location Address Fax Number:
520-746-4143
Provider Enumeration Date:
10/05/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X , with the licence number:  10255 , registered in the state of AZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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