Individual
JIMMY W COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
3501 S SONCY RD, SUITE 118, AMARILLO, TX 79119-6407
(806) 359-7999
(806) 355-7598
Mailing address
PO BOX 50360, AMARILLO, TX 79159-0360
(806) 351-1560
(806) 351-0343
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
233573
TX
367500000X
Certified Registered Nurse Anesthetist
R20232
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
85849U
BLUE CROSS & BLUE SHIELD
TX
Enumeration date
08/30/2006
Last updated
01/29/2008
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