Provider Demographics
NPI:1821149261
Name:COOKSEY, RONDA JANE (DC)
Entity Type:Individual
Prefix:
First Name:RONDA
Middle Name:JANE
Last Name:COOKSEY
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
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:972-294-4386
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:972-294-4386
Is Sole Proprietor?:No
Enumeration Date:2007-01-14
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9697111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8R3010Medicare UPIN