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General NPI Number Information
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NPI Number | 1801103056
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Entity Type | Organization
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Legal Business Name | LEWIS C COOK MD PA
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Dates
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Enumeration Date | 09/09/2010
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Last Update Date | 09/09/2010
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Provider Practice Location Address
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Address Line | 2323 KENNEDY LN
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City | TEXARKANA
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State | TX
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Zip | 75503-2536
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Country | US
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Telephone | 903-793-2020
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Fax | 903-793-7481
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Provider Business Mailing Address
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Address Line | 2323 KENNEDY LN
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City | TEXARKANA
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State | TX
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Zip | 75503-2536
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Country | US
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Telephone | 903-793-2020
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Fax | 903-793-7481
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. LEWIS C COOK
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Credential | MD
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Telephone | 903-793-2020
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | E1292
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License Number State | TX
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