Individual
DR. RAVEN MELISSA COOKSEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4910 MUELLER BLVD STE 200, AUSTIN, TX 78723-3079
(512) 628-1900
Mailing address
4910 MUELLER BLVD STE 200, AUSTIN, TX 78723-3079
(512) 628-1900
(512) 628-1901
Taxonomy
Speciality
Code
Description
License number
State
2080P0207X
Pediatric Hematology & Oncology Physician
Primary
R3300
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
371969203
—
TX
05
—
371969204
—
TX
01
—
577222YKZJ
MEDICARE
TX
Enumeration date
02/07/2007
Last updated
06/10/2022
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