Provider Demographics
NPI:1811963291
Name:COOK, JUDITH A (MD)
Entity type:Individual
Prefix:
First Name:JUDITH
Middle Name:A
Last Name:COOK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 2910
Mailing Address - Street 2:
Mailing Address - City:SHERMAN
Mailing Address - State:TX
Mailing Address - Zip Code:75091-2910
Mailing Address - Country:US
Mailing Address - Phone:903-892-6700
Mailing Address - Fax:903-892-6774
Practice Address - Street 1:121 W LAMBERTH RD
Practice Address - Street 2:SUITE A
Practice Address - City:SHERMAN
Practice Address - State:TX
Practice Address - Zip Code:75092-2661
Practice Address - Country:US
Practice Address - Phone:903-892-6700
Practice Address - Fax:903-892-6774
Is Sole Proprietor?:No
Enumeration Date:2006-02-27
Last Update Date:2016-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE08622084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8F1784Medicare PIN
C14725Medicare UPIN