Provider Demographics
NPI:1174642276
Name:COOPER, RHONDA (NP)
Entity Type:Individual
Prefix:
First Name:RHONDA
Middle Name:
Last Name:COOPER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 GREENWAY PLZ
Mailing Address - Street 2:SUITE 2950
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77046-0905
Mailing Address - Country:US
Mailing Address - Phone:713-580-9468
Mailing Address - Fax:713-358-4801
Practice Address - Street 1:9828 BLACKHAWK BLVD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77075-2246
Practice Address - Country:US
Practice Address - Phone:713-935-0333
Practice Address - Fax:713-935-9353
Is Sole Proprietor?:No
Enumeration Date:2007-03-28
Last Update Date:2009-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX609043363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8Y3605OtherBCBSTX
TX8L18338Medicare PIN