MEDICARE: DR. DOUK KOOK

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	1223G0001X	General Practice Dentistry	25151	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1821136714
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DOUK KOOK

Provider Business Mailing Address
First Line	:	870 S MASON RD
Second Line	:	STE. 144
City	:	KATY
State	:	TX
Zip	:	77450-3898
Country	:	US
Telephone Number	:	832-437-9154
Fax Number	:	832-437-9157

Provider Business Practice Location Address
First Line	:	1475 SAWDUST RD
Second Line	:	APT. #8203
City	:	SPRING
State	:	TX
Zip	:	77380-2145
Country	:	US
Telephone Number	:	520-245-3164
Fax Number	:

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

Provider Enumeration Date	:	02/02/2007
Last Update Date	:	02/29/2012

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Directions to “ DR. DOUK KOOK ” Practice Location

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