Provider Demographics
NPI:1366709180
Name:COOK, KENDRA LEE (PAC)
Entity type:Individual
Prefix:MRS
First Name:KENDRA
Middle Name:LEE
Last Name:COOK
Suffix:
Gender:F
Credentials:PAC
Other - Prefix:MISS
Other - First Name:KENDRA
Other - Middle Name:LEE
Other - Last Name:SPIVEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:6400 FANNIN ST STE 1700
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-1526
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9305 PINECROFT DR STE 400
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77380-3482
Practice Address - Country:US
Practice Address - Phone:713-486-8800
Practice Address - Fax:281-367-1323
Is Sole Proprietor?:No
Enumeration Date:2012-04-18
Last Update Date:2022-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA07699363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical