Provider Demographics
NPI:1184674632
Name:COOPER, RICHARD P (PAT) (PT)
Entity type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:P (PAT)
Last Name:COOPER
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3301 LONG PRAIRIE RD
Mailing Address - Street 2:SUITE 125
Mailing Address - City:FLOWER MOUND
Mailing Address - State:TX
Mailing Address - Zip Code:75022-2702
Mailing Address - Country:US
Mailing Address - Phone:972-874-7171
Mailing Address - Fax:972-874-7110
Practice Address - Street 1:3301 LONG PRAIRIE RD
Practice Address - Street 2:SUITE 125
Practice Address - City:FLOWER MOUND
Practice Address - State:TX
Practice Address - Zip Code:75022-2702
Practice Address - Country:US
Practice Address - Phone:972-874-7171
Practice Address - Fax:972-874-7110
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2013-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1048312225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8F0960Medicare ID - Type UnspecifiedPROVIDER ID NUMBER