Provider Demographics
NPI:1053092346
Name:COOPER, ISHARRA
Entity type:Individual
Prefix:MS
First Name:ISHARRA
Middle Name:
Last Name:COOPER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 13TH 14TH CONNECTOR APT 2405
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75074-6956
Mailing Address - Country:US
Mailing Address - Phone:214-607-8470
Mailing Address - Fax:
Practice Address - Street 1:701 13TH 14TH CONNECTOR APT 2405
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75074-6956
Practice Address - Country:US
Practice Address - Phone:214-607-8470
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-28
Last Update Date:2023-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care