Individual
JANINE LYNN COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA C
Contact information
Practice address
6560 FANNIN STREET, SUITE 1842, HOUSTON, TX 77030-2761
(713) 790-2089
(713) 794-0576
Mailing address
P. O. BOX 4346 DEPT 205, HOUSTON, TX 77210-4346
(713) 790-5227
(713) 790-5505
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA04724
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8N9697
BCBS
TX
Enumeration date
06/08/2006
Last updated
10/29/2007
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