Provider Demographics
NPI:1023000197
Name:COOK, RONALD L (DO)
Entity type:Individual
Prefix:DR
First Name:RONALD
Middle Name:L
Last Name:COOK
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 5865
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79408-5865
Mailing Address - Country:US
Mailing Address - Phone:806-743-2898
Mailing Address - Fax:806-743-2787
Practice Address - Street 1:3502 9TH ST
Practice Address - Street 2:SUITE 1C143
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79430-8143
Practice Address - Country:US
Practice Address - Phone:806-743-2757
Practice Address - Fax:806-743-2563
Is Sole Proprietor?:No
Enumeration Date:2005-08-16
Last Update Date:2021-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ6387207QG0300X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100152260AMedicaid
TX110751102Medicaid
NMB002OtherTRIWEST
NMJ9655Medicaid
NM71291Medicaid
TX82G887OtherBCBS
NM71291OtherPRESBYTERIAN COMMERCIAL
TX137761602Medicaid
TX137761607Medicaid
TX110751101OtherFIRSTCARE COMMERCIAL
TX80732ZOtherHMO BLUE