Provider Demographics
NPI:1497536171
Name:KOKENZIE, ADAM CASH (ATC, LAT, MAT)
Entity Type:Individual
Prefix:
First Name:ADAM
Middle Name:CASH
Last Name:KOKENZIE
Suffix:
Gender:M
Credentials:ATC, LAT, MAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7216 CROSS KEYS DR
Mailing Address - Street 2:
Mailing Address - City:NORTH RICHLAND HILLS
Mailing Address - State:TX
Mailing Address - Zip Code:76182-6056
Mailing Address - Country:US
Mailing Address - Phone:903-235-4373
Mailing Address - Fax:
Practice Address - Street 1:800 N WHITE CHAPEL BLVD
Practice Address - Street 2:
Practice Address - City:SOUTHLAKE
Practice Address - State:TX
Practice Address - Zip Code:76092-5141
Practice Address - Country:US
Practice Address - Phone:903-235-4373
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-10
Last Update Date:2023-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX20000155342255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer