Derek Cook, LAT
Individual provider Active NPI Athletic Trainer · Sweeny, TX
NPI 1386007102 · NPPES record last updated Mar 30, 2016
Key facts
- NPI
- 1386007102
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Athletic Trainer 2255A2300X
- License
- AT2396 (TX)
- Practice address
- 1310 N Elm St
Sweeny, TX 77480-1308 - Phone
- (979) 491-8159
- Fax
- (979) 491-8187
- NPI assigned
- Mar 30, 2016
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AT2396 | TX | MD | Athletic Trainer |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | AT2396 | TX | Yes |
Addresses
Primary practice location
1310 N Elm St
Sweeny, TX 77480-1308
Mailing address
1310 N Elm St
Sweeny, TX 77480-1308
Phone (979) 491-8159
Other providers in Sweeny, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 30, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.