Organization
HEALTHSOURCE OF COPPERFIELD, LLC
Active
Organization
HEALTHSOURCE OF COPPERFIELD, LLC
Active
Other names
HealthSource Chiropractic and Progressive Rehab
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ELIZABETH SMITH COOK DC (OWNER)
(214) 519-1755
Entity
Organization
Contact information
Practice address
8711 HIGHWAY 6 N STE 210, HOUSTON, TX 77095-2272
(281) 858-4446
Mailing address
8925 HIGHWAY 6 N, SUITE 200, HOUSTON, TX 77095-2457
(281) 858-4446
Taxonomy
Speciality
Code
Description
License number
State
111NR0400X
Rehabilitation Chiropractor
Primary
11457
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
410526ZK5A
MEDICARE PTAN
TX
Enumeration date
06/17/2016
Last updated
10/03/2018
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