Provider Demographics
NPI:1770570244
Name:COOK, PAUL CAMERON (MD)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:CAMERON
Last Name:COOK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 911230
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75391-1230
Mailing Address - Country:US
Mailing Address - Phone:972-997-8000
Mailing Address - Fax:972-234-0813
Practice Address - Street 1:915 GESSNER RD
Practice Address - Street 2:SUITE 720
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-2527
Practice Address - Country:US
Practice Address - Phone:713-830-9100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-09-30
Last Update Date:2009-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG3247208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP00664378OtherRAILROAD MEDICARE
TX103810103Medicaid
TX83C853OtherBLUE CROSS BLUE SHIELD
TX103810101Medicaid
TX8BP369OtherBLUECROSS BLUESHIELD OF TX
TX103810101Medicaid
TX8L5093Medicare PIN
TXE06994Medicare UPIN