Provider Demographics
NPI:1467088138
Name:COOK, DAVID
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:COOK
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6510 WESTWOOD CIR
Mailing Address - Street 2:
Mailing Address - City:LUMBERTON
Mailing Address - State:TX
Mailing Address - Zip Code:77657-7527
Mailing Address - Country:US
Mailing Address - Phone:409-617-8991
Mailing Address - Fax:
Practice Address - Street 1:6510 WESTWOOD CIR
Practice Address - Street 2:
Practice Address - City:LUMBERTON
Practice Address - State:TX
Practice Address - Zip Code:77657-7527
Practice Address - Country:US
Practice Address - Phone:409-617-8991
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-13
Last Update Date:2020-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health