Healthcare Provider Details

I. General information

NPI: 1255510004
Provider Name (Legal Business Name): MELVIN L. COHEN, M.D.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/29/2007
Last Update Date: 10/29/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14800 N US HIGHWAY 281 SUITE 110
SAN ANTONIO TX
78232-3733
US

IV. Provider business mailing address

14800 N US HIGHWAY 281 SUITE 110
SAN ANTONIO TX
78232-3733
US

V. Phone/Fax

Practice location:
  • Phone: 210-490-9850
  • Fax: 210-490-1465
Mailing address:
  • Phone: 210-490-9850
  • Fax: 210-490-1465

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberE8397
License Number StateTX

VIII. Authorized Official

Name: DR. MELVIN L. COHEN
Title or Position: DOCTOR
Credential: M.D.
Phone: 210-490-9850