Individual provider · Type 1 NPI
Idali Barraza Cooper, PNP
Pediatric Nurse Practitioner · El Paso, TX
NPI number
1639659337
Active
Practice location
11331 James Watt Dr Ste 600
El Paso, TX 79936-6401
Fax (915) 838-1406
Mailing address
849 Mallett St
El Paso, TX 79907-2418
Other practice locations
- 10755 Kenworthy St, El Paso, TX 79924-1717 · (915) 577-6515
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Primary Care Nurse Practitioner | 363LP2300X | AP137529 (TX) |
| Pediatric Nurse Practitioner Primary | 363LP0200X | AP137529 (TX) |
Pediatric Nurse Practitioner: Definition to come...
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About NPI 1639659337
Idali Barraza Cooper, PNP's National Provider Identifier is 1639659337, issued on Aug 21, 2018. The primary taxonomy on file is Pediatric Nurse Practitioner (363LP0200X), and the practice location is in El Paso, TX. The record was last updated on Aug 21, 2018.