Basic Information
| Provider Information | |||||||||
| NPI: | 1245402726 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | COOLEY | ||||||||
| FirstName: | ROBERT | ||||||||
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| Credential: | LOTA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3401 W PARMER LN | ||||||||
| Address2: | APARTMENT #831 | ||||||||
| City: | AUSTIN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 787274153 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 6001 W WILLIAM CANNON DR | ||||||||
| Address2: | BLDG I, SUITE 304 | ||||||||
| City: | AUSTIN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 787491968 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5123940652 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/25/2008 | ||||||||
| LastUpdateDate: | 03/25/2008 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 224Z00000X | 205189 | TX | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapy Assistant |
No ID Information.