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General NPI Number Information
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NPI Number | 1013201441
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Entity Type | Individual
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Provider Name | ACACIA COGNATA ACACIA COGNATA
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Gender | Female
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Dates
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Enumeration Date | 06/02/2011
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Last Update Date | 10/18/2022
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Provider Practice Location Address
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Address Line | 1 BAYLOR PLZ ROOM 022D
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City | HOUSTON
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State | TX
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Zip | 77030-3411
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Country | US
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Telephone | 832-646-9298
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Fax |
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Provider Business Mailing Address
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Address Line | 1617 ZENA LONA ST NE
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City | ALBUQUERQUE
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State | NM
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Zip | 87112-4535
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Country | US
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Telephone | 832-646-9298
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 557693
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 2080N0001X
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Taxonomy Name | Neonatal-Perinatal Medicine Physician
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License Number | MD2014-0734
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License Number State | NM
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Taxonomy #3
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Taxonomy Code | 2080N0001X
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Taxonomy Name | Neonatal-Perinatal Medicine Physician
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License Number | T9664
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License Number State | TX
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