Individual
DIANA CUEVAS COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1400 LAKE SHORE DR, WACO, TX 76708-3718
(254) 753-0291
Mailing address
4609 LEXINGTON ST, WACO, TX 76705-2376
(254) 644-9450
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2013314
TX
Other
Enumeration date
08/23/2018
Last updated
08/23/2018
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