Provider Demographics
NPI:1124599584
Name:COOPER, KAITLYN E (BS)
Entity Type:Individual
Prefix:MS
First Name:KAITLYN
Middle Name:E
Last Name:COOPER
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9777 W GULF BANK RD STE 5
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77040-3137
Mailing Address - Country:US
Mailing Address - Phone:281-970-5900
Mailing Address - Fax:281-970-5913
Practice Address - Street 1:16131 N ELDRIDGE PKWY STE 200
Practice Address - Street 2:
Practice Address - City:TOMBALL
Practice Address - State:TX
Practice Address - Zip Code:77377-9130
Practice Address - Country:US
Practice Address - Phone:281-970-5900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-11
Last Update Date:2019-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other