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NPI Code Detail

MEDICARE: MYRA S COOPER CRNA

MEDICARE: MYRA S COOPER CRNA
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
1367500000XCertified Registered Nurse AnesthetistCRNA000471NV
2367500000XCertified Registered Nurse AnesthetistAP117774TX
3367500000XCertified Registered Nurse AnesthetistNA3029CA

General Provider Information

NPI Number : 1487770624
Entity Type Code : Individual
Provider Name (Legal Business Name) : MYRA S COOPER CRNA
Provider Business Mailing Address
First Line : 6201 HARRY HINES BLVD
Second Line :
City : DALLAS
State : TX
Zip : 75235-5202
Country : US
Telephone Number : 214-648-2324
Fax Number : 214-645-9976
Provider Business Practice Location Address
First Line : 6201 HARRY HINES BLVD
Second Line :
City : DALLAS
State : TX
Zip : 75235-5202
Country : US
Telephone Number : 214-648-2324
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/21/2007
Last Update Date : 04/17/2026

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