Provider Demographics
NPI:1912042805
Name:ALLAN O COOK MD PA
Entity Type:Organization
Organization Name:ALLAN O COOK MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CARDIOTHORACIC AND VASCULAR SURGEON
Authorized Official - Prefix:DR
Authorized Official - First Name:ALLAN
Authorized Official - Middle Name:O
Authorized Official - Last Name:COOK
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD PA
Authorized Official - Phone:972-487-7057
Mailing Address - Street 1:777 WALTER REED BLVD
Mailing Address - Street 2:MEDICAL PLAZA II, SUITE # B10
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75042-5727
Mailing Address - Country:US
Mailing Address - Phone:972-487-7057
Mailing Address - Fax:972-272-4256
Practice Address - Street 1:5900 BERKSHIRE ROAD
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75072
Practice Address - Country:US
Practice Address - Phone:972-487-7057
Practice Address - Fax:972-272-4256
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-20
Last Update Date:2018-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF9322174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0032BRMedicare ID - Type Unspecified