NPIMap

Organization Active NPI

Cook Children's Physician Network

  • Pediatrics Physician
  • Fort Worth, TX
National Provider Identifier
1750369203
Registry record updated Jan 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
COOK CHILDREN'S PHYSICIAN NETWORK
Practice address
801 7TH Ave
Fort Worth, TX 76104-2733
Phone
(682) 885-6800
Fax
(682) 885-6729
NPI assigned
Jan 5, 2006
Last updated
Jan 16, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2024

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

Authorized official

Name
Matthew V Dzurik, MDNPI 1912094053
Title
President, CCPN
Phone
(682) 885-1416

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Genetics (M.D.) Physician 207SG0201X
Pediatrics Physician 208000000X Primary

Addresses

Primary practice location

801 7TH Ave
Fort Worth, TX 76104-2733

Mailing address

PO Box 733784
Dallas, TX 75373-3784
Phone (682) 885-1860

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040128000800 TX Part B Supplier - Clinic/Group Practice 7719884584 Receives reassigned benefits from 1,270 practitioners
5 other NPIs on this enrollment

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

17150 Euclid St
Ste 316
Fountain Vly, CA 92708
Phone (714) 486-3996

300 Pasteur Dr
Stanford, CA 94305
Phone (650) 498-5710

4444 E 41st St
Ste A
Tulsa, OK 74135
Phone (682) 303-0376

410 Lone Star Dr
Abilene, TX 79602
Phone (325) 690-6680

13340 Highland Hills Dr
Aledo, TX 76008
Phone (682) 303-3000

17 Care Cir
#100
Amarillo, TX 79124
Phone (432) 570-5693

1525 S Cooper St
Arlington, TX 76010
Phone (817) 804-1100

4443 N Josey Ln
Ste 160
Carrollton, TX 75010
Phone (972) 492-4242

209 N Bonnie Brae St
Denton, TX 76201
Phone (940) 243-0104

6210 John Ryan Dr
Ste 104
Fort Worth, TX 76132
Phone (682) 303-0800

6421 McCart Ave
Fort Worth, TX 76133
Phone (817) 263-7500

5680 Frisco Square Blvd
Ste 1200
Frisco, TX 75034
Phone (214) 618-3960

1300 W Lancaster Ave
Ste 204
Ft Worth, TX 76102
Phone (682) 885-2170

4405 River Oaks Blvd
Ft Worth, TX 76114
Phone (817) 624-1770

731 Martin Rd
Hurst, TX 76054
Phone (817) 514-0346

1006 Keller Pkwy
#103
Keller, TX 76248
Phone (817) 431-1450

1933 N Central Expy
Ste 520
McKinney, TX 75070
Phone (682) 303-1000

1350 N Preston Rd
Ste 40
Prosper, TX 75078
Phone (682) 885-6163

4100 W University Dr
Prosper, TX 75078
Phone (945) 204-1000

Practitioners & affiliated clinicians

Practitioners 1,299

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 1,299

NPI Registry JSON

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

{
    "created_epoch": "1136419200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705363200000",
    "number": "1750369203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 733784",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753733784",
            "telephone_number": "682-885-1860",
            "fax_number": "682-885-1396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 7TH AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761042733",
            "telephone_number": "682-885-6800",
            "fax_number": "682-885-6729"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COOK CHILDREN'S PHYSICIAN NETWORK",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-05",
        "last_updated": "2024-01-16",
        "certification_date": "2024-01-16",
        "status": "A",
        "authorized_official_last_name": "DZURIK",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "PRESIDENT, CCPN",
        "authorized_official_telephone_number": "682-885-1416",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207SG0201X",
            "taxonomy_group": "",
            "desc": "Medical Genetics, Clinical Genetics (M.D.)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.