Individual provider Active NPI

Deborah Tullos Cook, M.D.

  • Pediatrics Physician
  • Burleson, TX
National Provider Identifier
1457301962
Registry record updated Sep 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
K1401 Issued in TX
Practice address
312 E Renfro St
Suite 105
Burleson, TX 76028-3947
Phone
(817) 426-6887
NPI assigned
May 12, 2006
Last updated
Sep 14, 2015By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 14, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X K1401 TX Primary
Pediatrics Physician 208000000X 11049 MS

Addresses

Primary practice location

312 E Renfro St
Suite 105
Burleson, TX 76028-3947

Mailing address

312 E Renfro St
Suite 105
Burleson, TX 76028-3947
Phone (817) 426-6887

Other identifiers 1

IdentifierTypeStateIssuer
127510905MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
11049MSMDPediatrics Physician
K1401TXMDPediatrics Physician

Interoperability endpoints

  • Direct secure messaging: deborahcook@childcl.allscriptsdirect.net

NPI Registry JSON

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

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442188800000",
    "number": "1457301962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "312 E RENFRO ST",
            "address_2": "SUITE 105",
            "city": "BURLESON",
            "state": "TX",
            "postal_code": "760283947",
            "telephone_number": "817-426-6887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "312 E RENFRO ST",
            "address_2": "SUITE 105",
            "city": "BURLESON",
            "state": "TX",
            "postal_code": "760283947",
            "telephone_number": "817-426-6887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOK",
        "first_name": "DEBORAH",
        "middle_name": "TULLOS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-12",
        "last_updated": "2015-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "K1401",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MS",
            "license": "11049",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "127510905",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Burleson, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.