| Cooper Village Corporation | |
|
3518 Blue Meadow Ln Houston TX 77039-5720 | |
| (281) 771-4200 | |
| Not Available |
| Full Name | Cooper Village Corporation |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 3518 Blue Meadow Ln, Houston, Texas |
| Authorized Official Name and Position | Tyrena Lana Booker (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 2817714200 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Cooper Village Corporation 13202 Briar Forest Dr Apt 2124 Houston TX 77077-2444 Ph: (281) 771-4200 | Cooper Village Corporation 3518 Blue Meadow Ln Houston TX 77039-5720 Ph: (281) 771-4200 |
| NPI Number | 1710476775 |
|---|---|
| Provider Enumeration Date | 05/05/2018 |
| Last Update Date | 05/05/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710476775 | NPI | - | NPPES |
| 1356705024 | Medicaid | TX |
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