Healthcare Provider Details

I. General information

NPI: 1417232570
Provider Name (Legal Business Name): CAROLINE COHEN PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/19/2011
Last Update Date: 12/08/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2911 MEDICAL ARTS ST SUITE 3
AUSTIN TX
78705-3376
US

IV. Provider business mailing address

4305 CAMACHO ST
AUSTIN TX
78723-5390
US

V. Phone/Fax

Practice location:
  • Phone: 512-391-0175
  • Fax:
Mailing address:
  • Phone: 512-577-0162
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberN0001
License Number StateTX

VIII. Authorized Official

Name: DR. CAROLINE ENG COHEN
Title or Position: PHYSICIAN
Credential: MD
Phone: 512-577-0162