MEDICARE: DANIEL C COOK M.D.

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	208D00000X	General Practice Physician	H9861	TX

General Provider Information

NPI Number	:	1992760680
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIEL C COOK M.D.

Provider Business Mailing Address
First Line	:	6510 ABRAMS RD
Second Line	:	SUITE 645
City	:	DALLAS
State	:	TX
Zip	:	75231-7217
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6510 ABRAMS RD
Second Line	:	SUITE 645
City	:	DALLAS
State	:	TX
Zip	:	75231-7217
Country	:	US
Telephone Number	:	214-503-6362
Fax Number	:	214-553-1449

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

Provider Enumeration Date	:	04/18/2006
Last Update Date	:	07/08/2007

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