Provider Demographics
NPI:1043854094
Name:COOPER, JAMI ANN (PT, DPT)
Entity type:Individual
Prefix:
First Name:JAMI
Middle Name:ANN
Last Name:COOPER
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1841 COOPER RD
Mailing Address - Street 2:
Mailing Address - City:ZAVALLA
Mailing Address - State:TX
Mailing Address - Zip Code:75980-7407
Mailing Address - Country:US
Mailing Address - Phone:936-676-3324
Mailing Address - Fax:
Practice Address - Street 1:300 N JOHN REDDITT DR STE 1
Practice Address - Street 2:
Practice Address - City:LUFKIN
Practice Address - State:TX
Practice Address - Zip Code:75904-2634
Practice Address - Country:US
Practice Address - Phone:936-899-5325
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-03
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1321345225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist