Provider Demographics
NPI:1609169457
Name:COOPER, CALVIN MICHAEL (MD)
Entity Type:Individual
Prefix:DR
First Name:CALVIN
Middle Name:MICHAEL
Last Name:COOPER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:98 SAN JACINTO BLVD STE 1800
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78701-4237
Mailing Address - Country:US
Mailing Address - Phone:512-708-9700
Mailing Address - Fax:512-410-2942
Practice Address - Street 1:4101 JAMES CASEY ST STE 340
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78745-1145
Practice Address - Country:US
Practice Address - Phone:512-306-1323
Practice Address - Fax:512-306-1142
Is Sole Proprietor?:No
Enumeration Date:2011-05-25
Last Update Date:2022-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXR6540207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery