Provider Demographics
NPI:1043341605
Name:COOKSEY, ALAN WAYNE (LAT, ATC)
Entity Type:Individual
Prefix:MR
First Name:ALAN
Middle Name:WAYNE
Last Name:COOKSEY
Suffix:
Gender:M
Credentials:LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6361 VIA AVENTURA DR
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79912-1821
Mailing Address - Country:US
Mailing Address - Phone:915-584-9968
Mailing Address - Fax:
Practice Address - Street 1:20165 KASSERINE WAY
Practice Address - Street 2:
Practice Address - City:FORT BLISS
Practice Address - State:TX
Practice Address - Zip Code:79918-8064
Practice Address - Country:US
Practice Address - Phone:915-742-2457
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-07
Last Update Date:2022-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAT11752255A2300X
TX11752255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer