Provider Demographics
NPI:1356483416
Name:COONEY, TERESA (OPA-C)
Entity Type:Individual
Prefix:
First Name:TERESA
Middle Name:
Last Name:COONEY
Suffix:
Gender:F
Credentials:OPA-C
Other - Prefix:
Other - First Name:TERESA
Other - Middle Name:
Other - Last Name:KULA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OPA-C
Mailing Address - Street 1:9301 N CENTRAL EXPY STE 400
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-0805
Mailing Address - Country:US
Mailing Address - Phone:214-220-2468
Mailing Address - Fax:214-397-1555
Practice Address - Street 1:9301 N CENTRAL EXPY STE 400
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-0805
Practice Address - Country:US
Practice Address - Phone:214-220-2468
Practice Address - Fax:214-397-1555
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2009-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1002363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant