Provider Demographics
NPI:1043300478
Name:COOK, MATTHEW WILLIAM JR (DDS)
Entity type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:WILLIAM
Last Name:COOK
Suffix:JR
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5200 HOLLISTER
Mailing Address - Street 2:203
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77040-6298
Mailing Address - Country:US
Mailing Address - Phone:713-462-4581
Mailing Address - Fax:713-462-4582
Practice Address - Street 1:5200 HOLLISTER
Practice Address - Street 2:203
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77040-6298
Practice Address - Country:US
Practice Address - Phone:713-462-4581
Practice Address - Fax:713-462-4582
Is Sole Proprietor?:No
Enumeration Date:2006-10-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX66521223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice