Provider Demographics
NPI:1407932759
Name:COOPER, AARON DEAN
Entity Type:Individual
Prefix:
First Name:AARON
Middle Name:DEAN
Last Name:COOPER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:204 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HENNESSEY
Mailing Address - State:OK
Mailing Address - Zip Code:73742-1405
Mailing Address - Country:US
Mailing Address - Phone:405-853-7092
Mailing Address - Fax:
Practice Address - Street 1:1504 PASEO DEL PLATA
Practice Address - Street 2:SUITE 100
Practice Address - City:TEMPLE
Practice Address - State:TX
Practice Address - Zip Code:76502
Practice Address - Country:US
Practice Address - Phone:254-791-3800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist