Provider Demographics
NPI:1699875823
Name:COOKE, GREGORY CARRINGTON (MD)
Entity type:Individual
Prefix:MR
First Name:GREGORY
Middle Name:CARRINGTON
Last Name:COOKE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:146 HOSPITAL DRIVE
Mailing Address - Street 2:SUITE 208
Mailing Address - City:ANGLETON
Mailing Address - State:TX
Mailing Address - Zip Code:77515
Mailing Address - Country:US
Mailing Address - Phone:979-849-5940
Mailing Address - Fax:979-849-5944
Practice Address - Street 1:146 HOSPITAL DRIVE
Practice Address - Street 2:SUITE 208
Practice Address - City:ANGLETON
Practice Address - State:TX
Practice Address - Zip Code:77515
Practice Address - Country:US
Practice Address - Phone:979-849-5940
Practice Address - Fax:979-849-5944
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-25
Last Update Date:2009-06-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXK1402207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX10020035OtherAMERIGROUP
TX93491FOtherBLUE CROSS BLUE SHIELD
TX096694702Medicaid
TXG34242Medicare UPIN
TX93491FOtherBLUE CROSS BLUE SHIELD
TX096694702Medicaid