Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | J6387 | TX |
Y | 207QG0300X | Family Doctor - Geriatric Medicine | J6387 | TX |
NPI | 1023000197 |
---|---|
Provider Name | Dr. Ronald L. Cook |
First Address | Lubbock, TX 79408-5865 |
Second Address | Lubbock, TX 79430-8143 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/08/2005 |
Last Update Date | 02/12/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
100152260A | (05) | OK |
110751101 | FIRSTCARE COMMERCIAL (01) | TX |
110751102 | (05) | TX |
137761602 | (05) | TX |
137761607 | (05) | TX |
71291 | (05) | NM |
71291 | PRESBYTERIAN COMMERCIAL (01) | NM |
80732Z | HMO BLUE (01) | TX |
82G887 | BCBS (01) | TX |
B002 | TRIWEST (01) | NM |
F93415 | (02) | TX |
J9655 | (05) | NM |