Provider Demographics
NPI:1114922846
Name:COHEN, JEFFREY H (MD)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:H
Last Name:COHEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9157 HUEBNER RD
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78240-1502
Mailing Address - Country:US
Mailing Address - Phone:210-697-2020
Mailing Address - Fax:210-558-7679
Practice Address - Street 1:9157 HUEBNER RD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78240-1502
Practice Address - Country:US
Practice Address - Phone:210-697-2020
Practice Address - Fax:210-558-7679
Is Sole Proprietor?:No
Enumeration Date:2005-06-17
Last Update Date:2010-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL6833207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX160768101Medicaid
TX8H9492OtherBCBS
TX160768101Medicaid
TXC28301Medicare UPIN