Provider Demographics
NPI:1366678963
Name:COOPER, BRIAN JOEL (DO)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:JOEL
Last Name:COOPER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3901A SPICEWOOD SPRINGS RD
Mailing Address - Street 2:STE 201
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78759-8723
Mailing Address - Country:US
Mailing Address - Phone:737-226-6700
Mailing Address - Fax:
Practice Address - Street 1:3901A SPICEWOOD SPRINGS RD
Practice Address - Street 2:STE 201
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-8723
Practice Address - Country:US
Practice Address - Phone:737-226-6700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-09
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZR1687207R00000X
MS32537207R00000X
TN5471207R00000X
WI77922-21207R00000X
CA20A20883207R00000X
OH34.016499207R00000X
NVDO2534207R00000X
ALDO.3366207R00000X
IADO-06168207R00000X
NMDO2023-1032207R00000X
ARE-17825207R00000X
KY05759207R00000X
TXP1631207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXTXB156358Medicare PIN