Individual provider Active NPI

Cooper Pulliam

  • Certified Registered Nurse Anesthetist
  • Lubbock, TX
National Provider Identifier
1477400661
Registry record updated Oct 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
977212 Issued in TX
Practice address
3601 4TH St
Lubbock, TX 79430-0002
Phone
(806) 743-2981
NPI assigned
Mar 16, 2026
Last updated
Oct 9, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 9, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 977212 TX Primary

Addresses

Primary practice location

3601 4TH St
Lubbock, TX 79430-0002

Mailing address

2614 31St St
Lubbock, TX 79410-3430

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
977212TXMDCertified Registered Nurse Anesthetist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1773619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791504000000",
    "number": "1477400661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2614 31ST ST",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794103430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3601 4TH ST",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794300002",
            "telephone_number": "806-743-2981"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PULLIAM",
        "first_name": "COOPER",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2026-03-16",
        "last_updated": "2026-10-09",
        "certification_date": "2026-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "977212",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lubbock, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.