| Cook Children's Medical Center - Prosper | |
|
4200 W University Dr Prosper TX 75078-9805 | |
| (940) 484-4311 | |
| Not Available |
| Full Name | Cook Children's Medical Center - Prosper |
|---|---|
| Speciality | Psychologist |
| Location | 4200 W University Dr, Prosper, Texas |
| Authorized Official Name and Position | Cory R Rhoades (CHIEF FINANCIAL OFFICER) |
| Authorized Official Contact | 6828854880 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cook Children's Medical Center - Prosper Po Box 730108 Dallas TX 75373-0108 Ph: (682) 885-1860 | Cook Children's Medical Center - Prosper 4200 W University Dr Prosper TX 75078-9805 Ph: (940) 484-4311 |
| NPI Number | 1508578121 |
|---|---|
| Provider Enumeration Date | 12/14/2022 |
| Last Update Date | 06/10/2024 |
| Certification Date | 06/10/2024 |
| Medicare PECOS PAC ID | 9133599202 |
|---|---|
| Medicare Enrollment ID | O20250424002831 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508578121 | NPI | - | NPPES |
| Provider Name | Christina D York |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1902084510 PECOS PAC ID: 1951480888 Enrollment ID: I20080505000218 |
| Provider Name | Tahnae T Allen |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1982333217 PECOS PAC ID: 7719403567 Enrollment ID: I20250424002979 |
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