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General NPI Number Information
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NPI Number | 1598163271
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Entity Type | Organization
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Legal Business Name | COBB HEALTH CARE SERVICES, INC
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Dates
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Enumeration Date | 12/12/2014
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Last Update Date | 12/12/2014
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Provider Practice Location Address
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Address Line | 5863 WELLINGTON LN
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City | FRISCO
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State | TX
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Zip | 75033-2296
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Country | US
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Telephone | 469-337-5415
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Fax |
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Provider Business Mailing Address
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Address Line | 5863 WELLINGTON
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City | FRISCO
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State | TX
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Zip | 75033
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Country | US
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Telephone | 469-337-5415
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Fax |
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Authorized Official
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Title or Position | OWNER/ADMINISTRATOR
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Name | LAKISHA WATERS
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Credential |
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Telephone | 469-337-5415
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | 016509
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License Number State | TX
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