Provider Demographics
NPI:1932871134
Name:COOPER, XAVIER (DC)
Entity Type:Individual
Prefix:
First Name:XAVIER
Middle Name:
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 1:204 CENTRAL EXPY S STE 45
Mailing Address - Street 2:
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75013-8009
Mailing Address - Country:US
Mailing Address - Phone:214-383-9170
Mailing Address - Fax:
Practice Address - Street 1:204 CENTRAL EXPY S STE 45
Practice Address - Street 2:
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75013-8009
Practice Address - Country:US
Practice Address - Phone:214-383-9170
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-05
Last Update Date:2021-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14909111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor