Healthcare Provider Details

I. General information

NPI: 1558548396
Provider Name (Legal Business Name): JOSEPH I COHEN MD PA DBA CEDAR PARK PEDIATRICS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/23/2008
Last Update Date: 08/15/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12171 W PARMER LANE STE 201
CEDAR PARK TX
78613-7376
US

IV. Provider business mailing address

12171 W PARMER LANE STE 201
CEDAR PARK TX
78613-7376
US

V. Phone/Fax

Practice location:
  • Phone: 512-335-9600
  • Fax: 512-335-9696
Mailing address:
  • Phone: 512-335-9600
  • Fax: 512-335-9696

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberL7337
License Number StateTX

VIII. Authorized Official

Name: MR. JOSEPH I COHEN
Title or Position: OWNER/DOCTOR
Credential: MD
Phone: 512-335-9600