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General NPI Number Information
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NPI Number | 1619950847
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Entity Type | Individual
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Provider Name | GARY RICHARD COHEN M.D.
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Gender | Male
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Dates
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Enumeration Date | 11/22/2005
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Last Update Date | 11/23/2021
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Provider Practice Location Address
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Address Line | 45 NE LOOP 410 SUITE 900
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City | SAN ANTONIO
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State | TX
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Zip | 78216-5832
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Country | US
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Telephone | 210-375-7790
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 840853
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City | DALLAS
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State | TX
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Zip | 75284-5831
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Country | US
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Telephone | 972-233-1999
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Fax | 972-233-3666
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | H9855
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License Number State | TX
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