MEDICARE: DR. KATHERIN JOAN COOK DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	TX5069	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	82310Y	OTHER	TX	BLUE CROSS BLUE SHIELD
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1356362099
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KATHERIN JOAN COOK DC

Provider Business Mailing Address
First Line	:	1509 7TH ST
Second Line	:
City	:	BAY CITY
State	:	TX
Zip	:	77414-4923
Country	:	US
Telephone Number	:	979-244-2900
Fax Number	:	979-244-4554

Provider Business Practice Location Address
First Line	:	1509 7TH ST
Second Line	:
City	:	BAY CITY
State	:	TX
Zip	:	77414-4923
Country	:	US
Telephone Number	:	979-244-2900
Fax Number	:	979-244-4554

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/21/2006
Last Update Date	:	06/11/2013

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