Provider Demographics
NPI:1477692028
Name:JEANNINE ROZAS COOK, MD PA
Entity Type:Organization
Organization Name:JEANNINE ROZAS COOK, MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEANNINE
Authorized Official - Middle Name:ROZAS
Authorized Official - Last Name:COOK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-341-9696
Mailing Address - Street 1:1508 BONHAM CT
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75038-5900
Mailing Address - Country:US
Mailing Address - Phone:214-693-9230
Mailing Address - Fax:972-252-6341
Practice Address - Street 1:12200 PARK CENTRAL DR STE 405
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75251-2103
Practice Address - Country:US
Practice Address - Phone:972-341-9696
Practice Address - Fax:972-341-9697
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH2107208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty