MEDICARE: DR. ERIN COLLEEN COONEY MD

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	207SG0201X	Clinical Genetics (M.D.) Physician	Q9322	TX

General Provider Information

NPI Number	:	1679831093
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ERIN COLLEEN COONEY MD

Provider Business Mailing Address
First Line	:	1 BAYLOR PLZ
Second Line	:	BCM 320
City	:	HOUSTON
State	:	TX
Zip	:	77030-3411
Country	:	US
Telephone Number	:	832-824-1170
Fax Number	:

Provider Business Practice Location Address
First Line	:	2785 GULF FWY S STE 2.200
Second Line	:
City	:	LEAGUE CITY
State	:	TX
Zip	:	77573-4979
Country	:	US
Telephone Number	:	888-886-2543
Fax Number	:	409-772-3680

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

Provider Enumeration Date	:	04/24/2012
Last Update Date	:	10/30/2023

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