Individual
DR. CARNELL COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
12709 TOEPPERWEIN RD STE 302, LIVE OAK, TX 78233
(210) 653-9307
(210) 653-7014
Mailing address
12709 TOEPPERWEIN RD STE 302, LIVE OAK, TX 78233-3260
(210) 653-9307
(210) 653-7014
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
D40386
MD
208600000X
Surgery Physician
Primary
S1376
TX
2086S0102X
Surgical Critical Care Physician
D40386
MD
2086S0127X
Trauma Surgery Physician
S1376
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
071441100
—
MD
Enumeration date
06/26/2006
Last updated
05/05/2019
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