Provider Demographics
NPI:1528262532
Name:PAUL H COOK
Entity type:Organization
Organization Name:PAUL H COOK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:HUIE
Authorized Official - Last Name:COOK
Authorized Official - Suffix:JR
Authorized Official - Credentials:OD
Authorized Official - Phone:970-668-2020
Mailing Address - Street 1:PO BOX 2700
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:CO
Mailing Address - Zip Code:80443-2700
Mailing Address - Country:US
Mailing Address - Phone:970-668-2020
Mailing Address - Fax:970-668-0192
Practice Address - Street 1:620 MAIN STREET
Practice Address - Street 2:SUITE B
Practice Address - City:FRISCO
Practice Address - State:CO
Practice Address - Zip Code:80443
Practice Address - Country:US
Practice Address - Phone:970-668-2020
Practice Address - Fax:970-668-0192
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-13
Last Update Date:2015-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
COT60887Medicare UPIN
5805710001Medicare NSC
CO445038Medicare UPIN