Provider Demographics
NPI:1851463558
Name:COOPER, JAMES MARY (DC)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:MARY
Last Name:COOPER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:315 W HOUSTON ST
Mailing Address - Street 2:
Mailing Address - City:JASPER
Mailing Address - State:TX
Mailing Address - Zip Code:75951-4013
Mailing Address - Country:US
Mailing Address - Phone:409-384-3430
Mailing Address - Fax:409-384-0571
Practice Address - Street 1:315 W HOUSTON ST
Practice Address - Street 2:
Practice Address - City:JASPER
Practice Address - State:TX
Practice Address - Zip Code:75951-4013
Practice Address - Country:US
Practice Address - Phone:409-384-3430
Practice Address - Fax:409-384-0571
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2009-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9409111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor