| Organization Name: | COOK CHILDREN'S MEDICAL CENTER |
| NPI Number: | 1215236245 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | STEPHEN W KIMMEL (CFO, CCHCS) |
| Mailing Address: | 1500 Cooper St 4th Floor Fort Worth |
| State: | TX US |
| Postal Code: | 761042710 |
| Phone Number: | 6828852500 |
| Fax Number: | 6828851903 |
| NPI Enumeration Date: | 03/16/2011 |
| NPI Last Update Date: | 09/28/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101Y00000X |
| License Number: | 000332 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | TX |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |