Provider Demographics
NPI:1932119930
Name:COHEN, JOSEPH I (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:I
Last Name:COHEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:200 BUTTERCUP CREEK BLVD
Mailing Address - Street 2:SUITE # 100
Mailing Address - City:CEDAR PARK
Mailing Address - State:TX
Mailing Address - Zip Code:78613-3708
Mailing Address - Country:US
Mailing Address - Phone:512-335-9600
Mailing Address - Fax:512-335-9696
Practice Address - Street 1:200 BUTTERCUP CREEK BLVD
Practice Address - Street 2:SUITE # 100
Practice Address - City:CEDAR PARK
Practice Address - State:TX
Practice Address - Zip Code:78613-3708
Practice Address - Country:US
Practice Address - Phone:512-335-9600
Practice Address - Fax:512-335-9696
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-09
Last Update Date:2012-04-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXL7537208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX251923243OtherTAX ID
TX251923243OtherTAX ID