Provider Demographics
NPI:1528098191
Name:COOL, ANGELA LYNN (PHD)
Entity type:Individual
Prefix:DR
First Name:ANGELA
Middle Name:LYNN
Last Name:COOL
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:52 SUGAR CREEK CENTER BLVD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-2206
Mailing Address - Country:US
Mailing Address - Phone:281-242-1338
Mailing Address - Fax:832-939-8293
Practice Address - Street 1:52 SUGAR CREEK CENTER BLVD
Practice Address - Street 2:SUITE 300
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-2206
Practice Address - Country:US
Practice Address - Phone:281-242-1338
Practice Address - Fax:832-939-8293
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-03
Last Update Date:2014-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX32831103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8G2271OtherBCBS
TXQ59019Medicare UPIN
TX8G2271Medicare ID - Type Unspecified