1255323770 NPI number — JOHN COOPER HOWARD M.D.

Table of content: JOHN COOPER HOWARD M.D. (NPI 1255323770)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1255323770 NPI number — JOHN COOPER HOWARD M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HOWARD
Provider First Name:
JOHN
Provider Middle Name:
COOPER
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
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:
1255323770
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/29/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX K
Provider Second Line Business Mailing Address:
ONE MEDICAL CENTER DRIVE
Provider Business Mailing Address City Name:
CLARENDON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
79226-0300
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
806-874-3531
Provider Business Mailing Address Fax Number:
806-874-2244

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1 MEDICAL CENTER D
Provider Second Line Business Practice Location Address:
ONE MEDICAL CENTER DR.
Provider Business Practice Location Address City Name:
CLARENDON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
79226-0300
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
806-874-3531
Provider Business Practice Location Address Fax Number:
806-874-2244
Provider Enumeration Date:
08/19/2005

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: 207Q00000X , with the licence number:  G-6309 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 123790106 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 115488101 . This is a "FIRSTCARE" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 121515 . This is a "SUPERIOR" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 84130Y / 0044EB . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




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