Individual
JORDAN FAYTH COOKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
8101 S BROADWAY AVE, TYLER, TX 75703-5469
(903) 939-7500
(903) 939-7728
Mailing address
3414 GOLDEN RD, TYLER, TX 75701-8336
(903) 939-7500
(903) 939-7728
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA11584
TX
Other
Enumeration date
09/28/2017
Last updated
02/22/2022
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