Provider Demographics
NPI:1508810839
Name:COOK, THOMAS R (PA-C)
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:R
Last Name:COOK
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
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Mailing Address - Street 1:227 N LOOP 1604 E STE 150
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78232-1450
Mailing Address - Country:US
Mailing Address - Phone:210-901-5861
Mailing Address - Fax:855-847-0003
Practice Address - Street 1:227 N LOOP 1604 E STE 150
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78232-1450
Practice Address - Country:US
Practice Address - Phone:210-901-5861
Practice Address - Fax:855-847-0003
Is Sole Proprietor?:No
Enumeration Date:2006-05-20
Last Update Date:2019-10-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXPA05138363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant