Provider Demographics
NPI:1679763858
Name:COOKSEY CHIROPRACTIC, INCORPERATED
Entity Type:Organization
Organization Name:COOKSEY CHIROPRACTIC, INCORPERATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RONDA
Authorized Official - Middle Name:J
Authorized Official - Last Name:COOKSEY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:214-802-8750
Mailing Address - Street 1:1412 LAUREL HALL LN
Mailing Address - Street 2:
Mailing Address - City:LITTLE ELM
Mailing Address - State:TX
Mailing Address - Zip Code:75068-5572
Mailing Address - Country:US
Mailing Address - Phone:214-802-8750
Mailing Address - Fax:
Practice Address - Street 1:1412 LAUREL HALL LN
Practice Address - Street 2:
Practice Address - City:LITTLE ELM
Practice Address - State:TX
Practice Address - Zip Code:75068-5572
Practice Address - Country:US
Practice Address - Phone:214-802-8750
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-25
Last Update Date:2007-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9697111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0066MAOtherBLUE CROSS BLUE SHEILD
TX668055OtherACN GROUP