Organization
COOK CHILDREN'S PHYSICIAN NETWORK
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MATTHEW V DZURIK MD (PRESIDENT, CCPN)
(682) 885-1416
Entity
Organization
Contact information
Practice address
801 7TH AVE, FORT WORTH, TX 76104-2733
(682) 885-4095
(682) 885-7499
Mailing address
PO BOX 733784, DALLAS, TX 75373-3784
(682) 885-1860
(682) 885-1396
Taxonomy
Speciality
Code
Description
License number
State
207PP0204X
Pediatric Emergency Medicine (Emergency Medicine) Physician
Primary
—
—
208000000X
Pediatrics Physician
—
—
Other
Enumeration date
01/26/2006
Last updated
06/29/2021
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