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Individual

STANLEY D COOK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

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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