Individual
STEVEN J COHEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1327 TROUP HWY, TYLER, TX 75701-4443
(903) 510-8764
Mailing address
PO BOX 846098, DALLAS, TX 75284-6098
(903) 324-6450
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
J7933
TX
207RR0500X
Rheumatology Physician
Primary
J7933
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110115677
MEDICARE RAILROAD
TX
05
—
117681002
—
TX
05
—
117681004
—
TX
01
—
123033
CHIPS
TX
01
—
4110112
AETNA
TX
01
—
752616977061
TRICARE CHAMPUS
TX
01
—
83Y726
BCBS OF TEXAS
TX
01
—
CO083Y726
BCBS
TX
Enumeration date
02/10/2006
Last updated
04/01/2016
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