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General NPI Number Information
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NPI Number | 1477543734
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Entity Type | Individual
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Provider Name | CHARLES GREGORY COOPER JR. P.A.
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Gender | Male
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Dates
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Enumeration Date | 10/26/2005
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Last Update Date | 10/17/2025
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Provider Practice Location Address
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Address Line | 2410 CROCKETT DR STE A
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City | BROWNWOOD
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State | TX
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Zip | 76801-5981
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Country | US
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Telephone | 254-879-4900
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 5409
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City | ABILENE
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State | TX
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Zip | 79608-5409
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Country | US
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Telephone | 325-677-4904
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Fax | 325-677-5214
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA02722
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License Number State | TX
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