Basic Information
| Provider Information | |||||||||
| NPI: | 1396156857 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | COOK | ||||||||
| FirstName: | CALEB | ||||||||
| MiddleName: | JOHN | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5323 HARRY HINES BLVD | ||||||||
| Address2: | |||||||||
| City: | DALLAS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 753909087 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2144560488 | ||||||||
| FaxNumber: | 2144564486 | ||||||||
| Practice Location | |||||||||
| Address1: | 4015 22ND PL | ||||||||
| Address2: | |||||||||
| City: | LUBBOCK | ||||||||
| State: | TX | ||||||||
| PostalCode: | 79410 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8067256000 | ||||||||
| FaxNumber: | 8067237753 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/17/2014 | ||||||||
| LastUpdateDate: | 08/08/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 08/08/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208M00000X | R3654 | TX | N | Allopathic & Osteopathic Physicians | Hospitalist | 208000000X | R3654 | TX | Y | Allopathic & Osteopathic Physicians | Pediatrics |
No ID Information.