Provider Demographics
NPI:1467564401
Name:COOK, BILLY MAURICE (LCDC)
Entity Type:Individual
Prefix:MR
First Name:BILLY
Middle Name:MAURICE
Last Name:COOK
Suffix:
Gender:M
Credentials:LCDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5719 GLEN PINES DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77069-1818
Mailing Address - Country:US
Mailing Address - Phone:281-893-3114
Mailing Address - Fax:
Practice Address - Street 1:5719 GLEN PINES DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77069-1818
Practice Address - Country:US
Practice Address - Phone:281-893-3114
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1706101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor