MEDICARE: JACKIE COOPER

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
1	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1205327707
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JACKIE COOPER

Provider Business Mailing Address
First Line	:	12511 JONES MALTSBERGER RD APT 2205
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78247-4286
Country	:	US
Telephone Number	:	210-833-7163
Fax Number	:	210-855-7471

Provider Business Practice Location Address
First Line	:	12511 JONES MALTSBERGER RD APT 2205
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78247-4286
Country	:	US
Telephone Number	:	210-833-7163
Fax Number	:	210-855-7471

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/21/2018
Last Update Date	:	05/21/2018

Similar Medicare Providers

1881914000 — GRUPO MEDICO POLICLINICA SAN PEDRO MEDICARE ADVANTAGE
Practice Location Address:

211 CALLE MORSE
ARROYO, PR
00714-2350

Practice Phone: 787-839-3980
Practice Fax: 787-271-2515

1629310610 — EDDIE DAVIS, DPM, PLLC
Practice Location Address:

1314 E SONTERRA BLVD STE 2103
SAN ANTONIO, TX
78258-4286

Practice Phone: 210-829-8770
Practice Fax: 210-495-0242

1760994420 — WILLIAM A. TISDALL, M.D., P.A.
Practice Location Address:

1314 E SONTERRA BLVD STE 2107
SAN ANTONIO, TX
78258-4286

Practice Phone: 210-541-0700
Practice Fax: 210-541-6868

1306402342 — G&L MCGUIRE MANAGEMENT SERVICES, LLC
Practice Location Address:

1314 E SONTERRA BLVD STE 2101
SAN ANTONIO, TX
78258-4286

Practice Phone: 210-496-9993
Practice Fax: 866-373-7577

1396381224 — TEXAS STATE PHARMACY LLC
Practice Location Address:

1314 E SONTERRA BLVD STE 2102
SAN ANTONIO, TX
78258-4286

Practice Phone: 210-704-1551
Practice Fax: 210-907-7551

1235239823 — DR. KIMBERLY FARA CORBETT PSYD, MFT
Practice Location Address:

4411 30TH ST STE 101
SAN DIEGO, CA
92116-4286

Practice Phone: 619-298-2098
Practice Fax: 619-298-2098

Directions to “ JACKIE COOPER ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.