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Individual

MR. MELVIN L COOPER JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
AG-ACNP-BC

Contact information

Practice address
1106 COLLEGE ST STE C, BASTROP, TX 78602-3948
(512) 244-2895
(512) 244-2895
Mailing address
101 W LOUIS HENNA BLVD STE 300, AUSTIN, TX 78728-1203
(512) 492-3743
(512) 593-4444

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP133259
TX
363LA2100X
Acute Care Nurse Practitioner
AP133259
TX

Other

Enumeration date
02/14/2017
Last updated
08/18/2023
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