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General NPI Number Information
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NPI Number | 1821992066
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Entity Type | Organization
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Legal Business Name | TIMELESS WITH COCO, PLLC
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Dates
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Enumeration Date | 10/02/2026
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Last Update Date | 10/02/2026
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Provider Practice Location Address
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Address Line | 400 S ZANG BLVD STE 1412
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City | DALLAS
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State | TX
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Zip | 75208-6630
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Country | US
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Telephone | 469-655-2408
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Fax |
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Provider Business Mailing Address
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Address Line | 261 RUTGERS AVE
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City | RED OAK
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State | TX
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Zip | 75154-1645
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | NURSE PRACTITONER
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Name | COURTNEY JOHNSON
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Credential | DNP, APRN, WHNPBC
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Telephone | 469-655-2408
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number |
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License Number State | NULL
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