Provider Demographics
NPI:1225237217
Name:ROBERT D COOK, M.D. PA
Entity type:Organization
Organization Name:ROBERT D COOK, M.D. PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:FREDA
Authorized Official - Last Name:COOK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-467-0978
Mailing Address - Street 1:4150 N LAMAR BLVD
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78756-3716
Mailing Address - Country:US
Mailing Address - Phone:512-467-0978
Mailing Address - Fax:512-467-8066
Practice Address - Street 1:4150 N LAMAR BLVD
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78756-3716
Practice Address - Country:US
Practice Address - Phone:512-467-0978
Practice Address - Fax:512-467-8066
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-11
Last Update Date:2014-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE8402207KA0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXC14727Medicare UPIN
TX00918UMedicare ID - Type UnspecifiedMEDICARE GROUP NUMBER