Provider Demographics
NPI:1255730933
Name:COOK, CHINETRA C (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:CHINETRA
Middle Name:C
Last Name:COOK
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:DR
Other - First Name:CECE
Other - Middle Name:
Other - Last Name:COOK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:2300 MCCUE RD
Mailing Address - Street 2:# 434
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77056-4633
Mailing Address - Country:US
Mailing Address - Phone:832-449-8290
Mailing Address - Fax:
Practice Address - Street 1:5302 CORNISH ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77007-1912
Practice Address - Country:US
Practice Address - Phone:832-449-8290
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-19
Last Update Date:2014-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1221275225100000X, 2251G0304X, 2251S0007X, 2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics
No2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports