Healthcare Provider Details

I. General information

NPI: 1811813389
Provider Name (Legal Business Name): ABIGAIL COOPER RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2026
Last Update Date: 06/27/2026
Certification Date: 06/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3865 CHILDRESS AVE STE A
MESQUITE TX
75150-2808
US

IV. Provider business mailing address

1608 CALANQUES ST
ROYSE CITY TX
75189-5686
US

V. Phone/Fax

Practice location:
  • Phone: 972-528-6090
  • Fax:
Mailing address:
  • Phone: 214-334-3197
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP2201X
TaxonomyAmbulatory Care Registered Nurse
License Number1162814
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: