# COOK CHILDREN'S MEDICAL CENTER

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Cook Children's Psychology Clinics
- **Organization subpart:** No

## Provider details

- **NPI number:** 1710702907
- **Authorized official:** CORY R RHOADES (CHIEF FINANCIAL OFFICIER)
- **Authorized official phone:** (682) 885-4480

## Contact information

- **Practice address:** 1500 COOPER ST, FORT WORTH, TX 76104-2710
- **Practice address phone:** (682) 885-1480
- **Practice address fax:** (682) 885-3600
- **Mailing address:** PO BOX 99213, FORT WORTH, TX 76199-0213
- **Mailing address phone:** (682) 885-1860
- **Mailing address fax:** (682) 885-1396

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 103TC0700X | Clinical Psychologist | — | — | — |
| 103TC2200X | Clinical Child & Adolescent Psychologist | — | — | Yes |

## Other

- **Enumeration date:** 11/21/2024
- **Last updated:** 11/21/2024