Active NPI
Bruce Tyre Cooper, M.D., D.D.S.
- Plastic Surgery Physician
- Houston, TX
National Provider Identifier
1710090758
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Plastic Surgery Physician
- License
- 084143
- Practice address
- 12814 Willow Ctr
Suite B
Houston, TX 77066-3038 - Phone
- (281) 453-5300
- Fax
- (281) 453-5302
- NPI assigned
- Aug 16, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 6
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Oral and Maxillofacial Surgery (Dentist) | 1223S0112X | 12953 | TX | |
| Oral & Maxillofacial Surgery (D.M.D.) | 204E00000X | H2317 | TX | |
| Family Medicine Physician | 207Q00000X | H2317 | TX | |
| Family Medicine Physician | 207Q00000X | 084143 | MI | |
| Plastic Surgery Physician | 208200000X | H2317 | TX | |
| Plastic Surgery Physician | 208200000X | 084143 | MI | Primary |
Addresses
Primary practice location
12814 Willow Ctr
Suite B
Houston, TX 77066-3038
Mailing address
12814 Willow Ctr
Suite B
Houston, TX 77066-3038
Phone (281) 453-5300
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12953 | TX | MD | Addiction (Substance Use Disorder) Counselor |
| H2317 | TX | MD | Family Medicine Physician |
| 084143 | MI | MD | Plastic Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155686400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757548800000",
"number": "1710090758",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12814 WILLOW CTR",
"address_2": "SUITE B",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770663038",
"telephone_number": "281-453-5300",
"fax_number": "281-453-5302"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12814 WILLOW CTR",
"address_2": "SUITE B",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770663038",
"telephone_number": "281-453-5300",
"fax_number": "281-453-5302"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COOPER",
"first_name": "BRUCE",
"middle_name": "TYRE",
"name_prefix": "Dr.",
"credential": "M.D., D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-16",
"last_updated": "2025-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "1223S0112X",
"taxonomy_group": "",
"desc": "Dentist, Oral and Maxillofacial Surgery",
"state": "TX",
"license": "12953",
"primary": false
},
{
"code": "204E00000X",
"taxonomy_group": "",
"desc": "Oral & Maxillofacial Surgery",
"state": "TX",
"license": "H2317",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "TX",
"license": "H2317",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MI",
"license": "084143",
"primary": false
},
{
"code": "208200000X",
"taxonomy_group": "",
"desc": "Plastic Surgery",
"state": "TX",
"license": "H2317",
"primary": false
},
{
"code": "208200000X",
"taxonomy_group": "",
"desc": "Plastic Surgery",
"state": "MI",
"license": "084143",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Houston, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.