Cook, Gary S
Cook, Gary S is an individual health care provider with primary practice located at 1207 N Virginia St , Port Lavaca TX 77979-2506. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as his primary health care specialty. Cook, Gary S can be contacted via phone (361) 746-1588.Contact Information
Primary practice address
1207 N Virginia St
Port Lavaca TX 77979-2506
Phone: (361) 746-1588
Fax: (361) 400-1588
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Medical | 363AM0700X | PA0086 | Texas |
Profile Details
| NPI number | 1154325611 |
|---|---|
| LBN Legal business name | Cook, Gary S |
| Credentials | Physician Assistant (PA) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 11th, 2005 |
| Last updated | May 1st, 2014 - about 10 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1154325611 | NPPES |
| Texas | MEDICAID | 453897 |
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