MEDICARE: DR. ALLAN ODELL COOK JR. M.D.

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	2086S0129X	Vascular Surgery Physician	F9322	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1902842008
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALLAN ODELL COOK JR. M.D.

Provider Business Mailing Address
First Line	:	5900 BERKSHIRE RD
Second Line	:
City	:	MCKINNEY
State	:	TX
Zip	:	75072-6337
Country	:	US
Telephone Number	:	972-487-7057
Fax Number	:	972-272-4256

Provider Business Practice Location Address
First Line	:	2821 E PRESIDENT GEORGE BUSH HWY STE 506
Second Line	:
City	:	RICHARDSON
State	:	TX
Zip	:	75082-4278
Country	:	US
Telephone Number	:	972-487-7057
Fax Number	:	972-272-4256

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

Provider Enumeration Date	:	06/20/2006
Last Update Date	:	10/04/2018

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