Provider Demographics
NPI:1134319445
Name:HOOPER, LARRY E (PA)
Entity Type:Individual
Prefix:
First Name:LARRY
Middle Name:E
Last Name:HOOPER
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1322 SPACE PARK DR
Mailing Address - Street 2:A194
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77058-3400
Mailing Address - Country:US
Mailing Address - Phone:281-335-4601
Mailing Address - Fax:281-335-4685
Practice Address - Street 1:1322 SPACE PARK DR
Practice Address - Street 2:A194
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77058-3400
Practice Address - Country:US
Practice Address - Phone:281-335-4601
Practice Address - Fax:281-335-4685
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-01
Last Update Date:2007-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA00988363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health