Provider Demographics
NPI:1285641068
Name:COOK, HEIDI BETH (PA-C)
Entity Type:Individual
Prefix:
First Name:HEIDI
Middle Name:BETH
Last Name:COOK
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:HEIDI
Other - Middle Name:BETH
Other - Last Name:FRANKENFIELD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MPAS, PA-C
Mailing Address - Street 1:3509 DUMOND PL
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75025-2207
Mailing Address - Country:US
Mailing Address - Phone:972-208-1502
Mailing Address - Fax:
Practice Address - Street 1:5425 W SPRING CREEK PKWY STE 265
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75024-4344
Practice Address - Country:US
Practice Address - Phone:214-919-3500
Practice Address - Fax:214-919-3501
Is Sole Proprietor?:No
Enumeration Date:2006-08-02
Last Update Date:2013-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA04797363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8L13928Medicare PIN