Individual
PHILLIP COOK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD, BCPS
Contact information
Practice address
500 W 4TH ST, ODESSA, TX 79761-5001
(432) 640-6000
Mailing address
7444 103RD ST, LUBBOCK, TX 79424-6474
(314) 498-3172
Taxonomy
Speciality
Code
Description
License number
State
1835C0205X
Critical Care Pharmacist
Primary
63005
TX
1835P0200X
Pediatric Pharmacist
63005
TX
1835P1200X
Pharmacotherapy Pharmacist
63005
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
63005
TX PHARMACY LICENSE NO.
TX
Enumeration date
03/27/2020
Last updated
03/27/2020
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