MEDICARE: DEANDRA DEAUVEARO-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	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1720926868
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEANDRA DEAUVEARO-COOPER

Provider Business Mailing Address
First Line	:	1000 HIDDEN HILLS ST UNIT B
Second Line	:
City	:	MISSION
State	:	TX
Zip	:	78572-5486
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4500 N 10TH ST STE 400
Second Line	:
City	:	MCALLEN
State	:	TX
Zip	:	78504-2915
Country	:	US
Telephone Number	:	956-362-6636
Fax Number	:

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

Provider Enumeration Date	:	03/23/2026
Last Update Date	:	03/23/2026

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Directions to “ DEANDRA DEAUVEARO-COOPER ” Practice Location

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