Provider Demographics
NPI:1225162472
Name:LYN-COOK, RICHARD (MD, MPH)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:
Last Name:LYN-COOK
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2380 S MACGREGOR WAY
Mailing Address - Street 2:APT 256
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77021-1179
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3493 VETERANS DR N STE C
Practice Address - Street 2:
Practice Address - City:HUNTINGDON
Practice Address - State:TN
Practice Address - Zip Code:38344-6230
Practice Address - Country:US
Practice Address - Phone:731-986-2933
Practice Address - Fax:731-986-2938
Is Sole Proprietor?:No
Enumeration Date:2007-03-16
Last Update Date:2023-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY219372207R00000X, 208000000X
TXM6734207R00000X, 208000000X
TN62927207R00000X, 208000000X
TNMD62927208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ079387Medicaid
TX8K5362Medicare PIN