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General NPI Number Information
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NPI Number | 1720483852
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Entity Type | Organization
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Legal Business Name | DR J W COOPER, PLLC
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Dates
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Enumeration Date | 10/31/2014
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Last Update Date | 10/31/2014
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Provider Practice Location Address
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Address Line | 500 N CENTRAL EXPY STE 260
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City | PLANO
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State | TX
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Zip | 75074-6772
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Country | US
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Telephone | 972-837-6782
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Fax |
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Provider Business Mailing Address
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Address Line | 500 N CENTRAL EXPY STE 260
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City | PLANO
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State | TX
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Zip | 75074-6772
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Country | US
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Telephone | 972-837-6782
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Fax |
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Authorized Official
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Title or Position | PSYCHOLOGIST
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Name | DR. JASON WILLIAM COOPER
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Credential | PH.D.
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Telephone | 972-837-6782
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 36836
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License Number State | TX
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