NPIMap

Individual provider Active NPI

Gary S Cook, P.A.

  • Medical Physician Assistant
  • Port Lavaca, TX
National Provider Identifier
1154325611
Registry record updated May 1, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA0086 Issued in TX
Practice address
1207 N Virginia St
Port Lavaca, TX 77979-2506
Phone
(361) 746-1588
Fax
(361) 400-1588
NPI assigned
Jun 11, 2005
Last updated
May 1, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA0086 TX Primary

Addresses

Primary practice location

1207 N Virginia St
Port Lavaca, TX 77979-2506

Mailing address

1207 N Virginia St
Port Lavaca, TX 77979-2506
Phone (361) 746-1588

Other identifiers 1

IdentifierTypeStateIssuer
453897MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110315001063 TX Practitioner - Physician Assistant 5799717864 Reassigns benefits to 8 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

200 Hospital Dr
Anahuac, TX 77514-1638
Phone (409) 267-3143

621 S Ross Sterling
Anahuac, TX 77514-1638
Phone (409) 267-4126

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
610MTMDClinical Social Worker
PA0086TXMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Chambers County Public Hospital District No 1 CurrentSince Oct 1, 2025 Accepting new patients
El Campo Memorial Hospital CurrentSince Jun 17, 2019 Accepting new patients
Chambers County Public Hospital District No 1 CurrentSince Jul 1, 2020 Accepting new patients
El Campo Memorial Hospital CurrentSince Jun 17, 2019 Accepting new patients
Chambers County Public Hospital District No. 1 CurrentSince Jul 1, 2020 Accepting new patients
Palacios Community Medical Center CurrentSince Jul 16, 2012 Accepting new patients
New Vitality Clinic Past Accepting new patients
Chambers County Public Hospital District No 1 Past Accepting new patients

Locations

303 Sandy Corner Rd
El Campo, TX 77437
Phone (979) 543-6251

311 Green Ave
Palacios, TX 77465
Phone (361) 972-2511

Organizations & group practices 14

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 14

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1118448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398902400000",
    "number": "1154325611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1207 N VIRGINIA ST",
            "city": "PORT LAVACA",
            "state": "TX",
            "postal_code": "779792506",
            "telephone_number": "361-746-1588",
            "fax_number": "361-400-1588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1207 N VIRGINIA ST",
            "city": "PORT LAVACA",
            "state": "TX",
            "postal_code": "779792506",
            "telephone_number": "361-746-1588",
            "fax_number": "361-400-1588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOK",
        "first_name": "GARY",
        "middle_name": "S",
        "name_prefix": "Mr.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-11",
        "last_updated": "2014-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TX",
            "license": "PA0086",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "453897",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Lavaca, TX

Sources for this page

Verify at the official NPI Registry.