# COOK CHILDREN'S MEDICAL CENTER - PROSPER

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** COOK CHILDREN'S MEDICAL CENTER - PROSPER
- **Other names:** Cook Children's Psychology Prosper
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1508578121
- **Legal business name:** COOK CHILDREN'S MEDICAL CENTER - PROSPER
- **Authorized official:** CORY R RHOADES (CHIEF FINANCIAL OFFICER)
- **Authorized official phone:** (682) 885-4880

## Contact information

- **Practice address:** 4200 W UNIVERSITY DR, PROSPER, TX 75078-9805
- **Practice address phone:** (940) 484-4311
- **Mailing address:** PO BOX 730108, DALLAS, TX 75373-0108
- **Mailing address phone:** (682) 885-1860
- **Mailing address fax:** (682) 885-1396

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 103G00000X | Clinical Neuropsychologist | — | — | — |
| 103T00000X | Psychologist | — | — | — |
| 103TC2200X | Clinical Child & Adolescent Psychologist | — | — | Yes |

## Other

- **Enumeration date:** 12/14/2022
- **Last updated:** 06/10/2024