Individual
CODY M COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CPHT
Contact information
Practice address
12815 INDIANA AVE, LUBBOCK, TX 79423-5677
(806) 776-8915
Mailing address
7117 19TH ST APT 1603, LUBBOCK, TX 79407-1376
(806) 778-7935
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
217641
TX
183700000X
Pharmacy Technician
PT00011253
NM
Other
Enumeration date
10/26/2020
Last updated
10/26/2020
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