=====================================================
General NPI Number Information
=====================================================
NPI Number | 1417232570
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CAROLINE COHEN PA
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/19/2011
-----------------------------------------------------
Last Update Date | 12/08/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2911 MEDICAL ARTS ST SUITE 3
-----------------------------------------------------
City | AUSTIN
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78705-3376
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 512-391-0175
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4305 CAMACHO ST
-----------------------------------------------------
City | AUSTIN
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78723-5390
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 512-577-0162
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PHYSICIAN
-----------------------------------------------------
Name | DR. CAROLINE ENG COHEN
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 512-577-0162
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207V00000X
-----------------------------------------------------
Taxonomy Name | Obstetrics & Gynecology Physician
-----------------------------------------------------
License Number | N0001
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------