Provider Demographics
NPI:1821048992
Name:COOK, ROBERT SYLVESTER (PSYCH)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:SYLVESTER
Last Name:COOK
Suffix:
Gender:M
Credentials:PSYCH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7021 KEWANEE AVE
Mailing Address - Street 2:7101
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79424-7048
Mailing Address - Country:US
Mailing Address - Phone:806-763-0173
Mailing Address - Fax:806-763-8047
Practice Address - Street 1:7021 KEWANEE AVE
Practice Address - Street 2:7101
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79424-7048
Practice Address - Country:US
Practice Address - Phone:806-763-0173
Practice Address - Fax:806-763-8047
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2012-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT4787371-2501103TC0700X
TX26871103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical