Individual
STANLEY D COOK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1901 MEDI PARK DR, SUITE 2050, AMARILLO, TX 79106-2110
(806) 355-3352
(806) 355-5367
Mailing address
PO BOX 3780, AMARILLO, TX 79116-3780
(806) 355-3352
(806) 355-5367
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
G7503
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100130410A
—
OK
05
—
129122103
—
TX
05
—
129122106
—
TX
01
—
137298101
FIRSTCARE
—
05
—
16533038
—
NM
01
—
751375446
TAX ID
—
01
—
8F7707
BLUE CROSS OF TEXAS
TX
01
—
MDG7503
TEXAS WORKERS COMPENSATIO
TX
01
—
P00338146
RAILROAD MEDICARE
—
Enumeration date
07/19/2005
Last updated
06/11/2008
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