Provider Demographics
NPI:1194711531
Name:COFER, JOSEPH SHEPHERD (PA-C)
Entity type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:SHEPHERD
Last Name:COFER
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2833 BABCOCK RD STE 435
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-4850
Mailing Address - Country:US
Mailing Address - Phone:210-705-5060
Mailing Address - Fax:
Practice Address - Street 1:2833 BABCOCK RD STE 435
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-4850
Practice Address - Country:US
Practice Address - Phone:210-705-5060
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-09-21
Last Update Date:2025-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH50.002274363AS0400X
TXPA14640363A00000X
NC0010-03143363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0397730007Medicare NSC