Provider Demographics
NPI:1134304371
Name:HOOKER, KOBY BRANDON (PT)
Entity Type:Individual
Prefix:MR
First Name:KOBY
Middle Name:BRANDON
Last Name:HOOKER
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 CLOISTER PKWY
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79121-1715
Mailing Address - Country:US
Mailing Address - Phone:806-336-8740
Mailing Address - Fax:
Practice Address - Street 1:7120 SW 9TH AVE
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79106
Practice Address - Country:US
Practice Address - Phone:806-336-8740
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-07
Last Update Date:2018-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1078830225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8T1455OtherBCBS PROVIDER NO
TX8D0647Medicare PIN
TX8T1455OtherBCBS PROVIDER NO