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NPI Code Detail

MEDICARE: DR. MARK D. COONEY O.D.

MEDICARE:  DR. MARK D. COONEY  O.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1152W00000XOptometrist3121TTX

General Provider Information

NPI Number : 1144219353
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MARK D. COONEY O.D.
Provider Business Mailing Address
First Line : 8055 WEST AVE
Second Line : SUITE 109
City : SAN ANTONIO
State : TX
Zip : 78213-1841
Country : US
Telephone Number : 210-340-1919
Fax Number : 210-348-0348
Provider Business Practice Location Address
First Line : 8055 WEST AVE
Second Line : SUITE 109
City : SAN ANTONIO
State : TX
Zip : 78213-1841
Country : US
Telephone Number : 210-340-1919
Fax Number : 210-348-0348
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/19/2005
Last Update Date : 07/08/2007

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Directions to “ DR. MARK D. COONEY O.D.” Practice Location

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