Healthcare Provider Details

I. General information

NPI: 1548447824
Provider Name (Legal Business Name): YURI E. COOK, M.D., PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/29/2008
Last Update Date: 05/30/2023
Certification Date: 05/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 RAINTREE CIR STE 240
ALLEN TX
75013-4902
US

IV. Provider business mailing address

1111 RAINTREE CIR STE 240
ALLEN TX
75013-4902
US

V. Phone/Fax

Practice location:
  • Phone: 214-644-0280
  • Fax: 214-644-0294
Mailing address:
  • Phone: 214-644-0280
  • Fax: 214-644-0294

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. YURI E COOK
Title or Position: PRESIDENT, OWNER
Credential: MD
Phone: 214-644-0280