Individual
JOHN DEREK COGDILL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OT
Contact information
Practice address
309 PLANTATION DR, LAKE JACKSON, TX 77566-6142
(979) 418-7165
(800) 419-5153
Mailing address
309 PLANTATION DR, LAKE JACKSON, TX 77566-6142
(979) 418-7165
(800) 419-5153
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
212525
TX
225X00000X
Occupational Therapist
Primary
122982
TX
Other
Enumeration date
07/07/2022
Last updated
08/30/2022
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