Individual
DESHEA LYNN COOK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
224 GOLDENEYE LN, FORT WORTH, TX 76120-1626
(817) 939-9152
Mailing address
224 GOLDENEYE LN, FORT WORTH, TX 76120-1626
(817) 939-9152
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
04/12/2013
Last updated
04/12/2013
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