Individual
ELLIOTT LEE COHEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
201 WALLS DR, WALLS REGIONAL, CLEBURNE, TX 76033-4007
(817) 641-2551
Mailing address
1802 LEEDS DR, SOUTHLAKE, TX 76092-3576
(817) 421-5007
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
L6328
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
161179008
—
TX
Enumeration date
06/26/2006
Last updated
07/28/2008
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