MEDICARE: TRINA N MILFORD COOK CHW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	172V00000X	Community Health Worker	10475	TX

General Provider Information

NPI Number	:	1225859465
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TRINA N MILFORD COOK CHW

Provider Business Mailing Address
First Line	:	21210 SPRINGBROOK HOLLOW CT
Second Line	:
City	:	KLEIN
State	:	TX
Zip	:	77379-1941
Country	:	US
Telephone Number	:	832-562-8164
Fax Number	:

Provider Business Practice Location Address
First Line	:	2000 CRAWFORD ST STE 1639
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77002-1367
Country	:	US
Telephone Number	:	832-562-8164
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/21/2024
Last Update Date	:	10/21/2024

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Directions to “ TRINA N MILFORD COOK CHW” Practice Location

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