MS. DEIDRE MONIQUE COOPERWOOD (NPI# 1083017362) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083017362 |
| Entity Type | Individual |
| Full Name | MS. DEIDRE MONIQUE COOPERWOOD |
| Credential | PA-C |
| Practice Address |
1515 Truemper St Bldg. 6612 Lackland Afb TX 78236-5583 |
| Practice Telephone | 2106715535 |
| Mailing Telephone | 2106715535 |
| Enumeration Date | 2014-10-01 |
| Last Update Date | 2014-10-01 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1515 TRUEMPER ST BLDG. 6612 |
| City | LACKLAND AFB |
| State | TX |
| Zip Code | 78236-5583 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326435751 | Ashley Mcnealy | Military Health Care Provider | 1515 Truemper St, Lackland Afb, TX 78236-5583 | 2015-04-23 |
| 1811264864 | Colleen Varga | Psychologist | 1515 Truemper St, Lackland Afb, TX 78236-5583 | 2011-11-18 |
| 1326226200 | Manuel A Nunez | General Practice | 1515 Truemper St, Lackland Afb, TX 78236-5583 | 2008-02-04 |
| 1972788966 | Peter Paily | Family Medicine | 1515 Truemper St, Lackland Afb, TX 78236-5583 | 2008-01-08 |
| 1982886669 | Noirin Caitlian Horgan | Nurse Practitioner | 1515 Truemper St, Lackland Afb, TX 78236-5583 | 2007-12-04 |
| 1083808240 | Louise Kim Feuge | Nurse Practitioner | 1515 Truemper St, Lackland Afb, TX 78236-5583 | 2007-08-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063047363 | Arnoldo Arturo Gonzalez Jr. | Specialist/Technologist | 1033 Truemper St, Lackland Afb, TX 78236 | 2020-03-06 |
| 1023643343 | Meredith Grace Cockerell | Specialist/Technologist | W Military Drive, San Antonio, TX 78236 | 2020-03-06 |
| 1578120598 | Hali Rashelle Hall | Dentist | 1615 Truemper St, Blg 6418, Attn: 59ds/sgdn, Jbsa Lackland, TX 78236 | 2019-05-24 |
| 1952967077 | Paul Fianza Boseman | Nurse Practitioner | 1106 Wilford Hall Loop, San Antonio, TX 78236 | 2019-05-14 |
| 1689161978 | Kelly Jones Buckshire | Dentist | Dunn Dental Clinic, 1615 Truemper Rd, San Antonio, TX 78236 | 2018-04-23 |
| 1902308570 | Roger Louis Farney | Student in an Organized Health Care Education/Training Program | 1100 Wilford Hall Loop Bldg. 4554, Jbsa Lackland Afb, TX 78236 | 2018-02-28 |
| 1568916856 | Thomas Maxwell Woolf | Dentist | 1100 Wilford Hall Ambulatory Surgical Center, Lackland Afb, TX 78236 | 2016-08-04 |
| 1831544956 | Michael Veronneau | Student in an Organized Health Care Education/Training Program | 59 Mdw/ge 1100 Wilford Hall Loop, Bldg. 4554, Jbsa Lackland, TX 78236 | 2016-04-26 |
| 1376906958 | David Kephart Jr. | General Practice | 1100 Wilford Hall Loop Bldg 4454, Jbsa Lackland, TX 78236 | 2016-04-01 |
| 1184084089 | Olivia Arballo | Dermatology | Wilford Hall Asc, Attn: Dept of Dermatology, 1100 Wilford Hall Loop Bldg 4554, Jbsa-lackland, TX 78236 | 2016-03-04 |
| Find all providers in zip 78236 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992057178 | Drew Edward Lancaster | Physician Assistant | 1515 Truemper St Bldg 6612, Lackland Afb, TX 78236-5583 | 2012-10-11 |
| 1700081627 | Kathryn Elizabeth Kasper | Physician Assistant | 1100 Wilford Hall Loop Ste 1, Lackland Afb, TX 78236-5638 | 2007-06-20 |
| 1225016694 | Dennis Jay Robinson | Physician Assistant | 2200 Berquist Drive, Suite 1 Attn: Credentials (cmc), Lackland Afb, TX 78236-6300 | 2006-01-05 |
| 1154310522 | Richard V Ray | Physician Assistant | Whasc, 2200 Bergquist Dr, Lackland Afb, TX 78236 | 2005-10-19 |
| 1659826071 | James Tyrone Harris Jr. | Physician Assistant | Wilford Hall Ambulatory Surgical Center, 1100 Wilford Hall Loop, Lackland Afb, TX 78236 | 2016-08-16 |
| 1861827990 | Jessica Rae Davis | Physician Assistant | 1515 Truemper St Bldg 6612, Lackland Afb, TX 78236-5583 | 2013-09-09 |
| 1245540566 | Emmalyn V. Tague | Physician Assistant | 2200 Berquist Dr, Lackland Afb, TX 78236-6040 | 2010-10-20 |
| 1356475156 | Barbara R Jean | Physician Assistant | 2200 Bergquist Dr, Suite 1, Lackland Afb, TX 78236-9907 | 2007-03-15 |
| 1467430421 | Rene Marie Mcqueen | Physician Assistant | 1100 Wilford Hall Loop, Lackland Afb, TX 78236-5638 | 2006-01-09 |
| 1629056064 | Melody Vinson | Physician Assistant | 2200 Berquist Drive, Suite 1 Attn: Credentials ( Cmc), Lackland Afb, TX 78236-5300 | 2006-01-05 |
| Find all providers in LACKLAND AFB | ||||
| City | LACKLAND AFB |
| Zip Code | 78236 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.