Provider Demographics
NPI:1285729095
Name:COOPER, JAMES WILLIS (DDS)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:WILLIS
Last Name:COOPER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:5756 S STAPLES ST
Mailing Address - Street 2:SUITE I
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78413-3782
Mailing Address - Country:US
Mailing Address - Phone:361-991-7791
Mailing Address - Fax:361-992-1969
Practice Address - Street 1:5756 S STAPLES ST
Practice Address - Street 2:SUITE I
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78413-3782
Practice Address - Country:US
Practice Address - Phone:361-991-7791
Practice Address - Fax:361-992-1969
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX99971223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice