Idali Barraza Cooper, PNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

AP137529 Issued in TX

Practice address

11331 James Watt Dr Ste 600
El Paso, TX 79936-6401

Phone

(915) 838-1400

Fax

(915) 838-1406

NPI assigned

Aug 21, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1534809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534809600000",
    "number": "1639659337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "849 MALLETT ST",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799072418",
            "telephone_number": "915-248-7928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11331 JAMES WATT DR STE 600",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799366401",
            "telephone_number": "915-838-1400",
            "fax_number": "915-838-1406"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10755 Kenworthy St",
            "address_purpose": "LOCATION",
            "city": "El Paso",
            "state": "TX",
            "postal_code": "799241717",
            "country_code": "US",
            "telephone_number": "915-577-6515",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COOPER",
        "first_name": "IDALI",
        "middle_name": "BARRAZA",
        "name_prefix": "Mrs.",
        "credential": "PNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-21",
        "last_updated": "2018-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "TX",
            "license": "AP137529",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TX",
            "license": "AP137529",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patrick R Cook, D.O.
• Jennifer L Cooley, MD
• Mary Elizabeth Cooley, M.A.,M.S.W.,L.I.S.W.
• Michael E Cooney, CRNA
• Courtnee Cooper, RN
• Theodore Cooper
• Abby Cooperman, LCSW, LPC
• Coordinated Skilled Care, Inc.
• Rocio Copado, LCDC
• Arthur Richard Copeland, MD

• Pediatric Nurse Practitioner in El Paso, TX
• Providers in El Paso, TX by specialty
• Pediatric Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2018; 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.