Individual
MRS. IDALI BARRAZA COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PNP
Contact information
Practice address
11331 JAMES WATT DR STE 600, EL PASO, TX 79936-6401
(915) 838-1400
(915) 838-1406
Mailing address
849 MALLETT ST, EL PASO, TX 79907-2418
(915) 248-7928
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
AP137529
TX
363LP2300X
Primary Care Nurse Practitioner
AP137529
TX
Other
Enumeration date
08/21/2018
Last updated
08/21/2018
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