Healthcare Provider Details

I. General information

NPI: 1871663476
Provider Name (Legal Business Name): PAUL ISSA COOK M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/09/2006
Last Update Date: 01/07/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6400 FANNIN ST SUITE 1900
HOUSTON TX
77030-1528
US

IV. Provider business mailing address

6400 FANNIN ST SUITE 1900
HOUSTON TX
77030-1528
US

V. Phone/Fax

Practice location:
  • Phone: 713-796-2200
  • Fax: 713-796-2232
Mailing address:
  • Phone: 713-796-2200
  • Fax: 713-796-2232

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberH6130
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: