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General NPI Number Information
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NPI Number | 1831326636
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Entity Type | Individual
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Provider Name | MELODY RAE COOK CRNFA
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Gender | Female
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Dates
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Enumeration Date | 06/18/2009
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Last Update Date | 03/28/2023
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Provider Practice Location Address
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Address Line | 3500 GASTON AVE
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City | DALLAS
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State | TX
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Zip | 75246-2017
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Country | US
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Telephone | 214-577-8930
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Fax |
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Provider Business Mailing Address
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Address Line | 1525 SPRINGTREE CIR
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City | RICHARDSON
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State | TX
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Zip | 75082-4723
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Country | US
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Telephone | 972-235-7587
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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 | 163WR0006X
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Taxonomy Name | Registered Nurse First Assistant
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License Number | 706544
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License Number State | TX
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