Provider Demographics
NPI:1336514512
Name:COOPER, LAUREN OSBORNE (MCN, RD, LD)
Entity Type:Individual
Prefix:MRS
First Name:LAUREN
Middle Name:OSBORNE
Last Name:COOPER
Suffix:
Gender:F
Credentials:MCN, RD, LD
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:CHRISTINA
Other - Last Name:OSBORNE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 845347
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-5347
Mailing Address - Country:US
Mailing Address - Phone:214-645-8600
Mailing Address - Fax:214-645-0078
Practice Address - Street 1:5323 HARRY HINES BLVD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75390-7201
Practice Address - Country:US
Practice Address - Phone:214-645-8600
Practice Address - Fax:214-645-0078
Is Sole Proprietor?:No
Enumeration Date:2015-12-14
Last Update Date:2016-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT83487133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered