Organization
BRETT L. COCHRUM, MD, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRETT LANDON COCHRUM MD (OWNER)
(817) 294-4959
Entity
Organization
Contact information
Practice address
6210 JOHN RYAN DR, STE 109A, FORT WORTH, TX 76132-4113
(817) 294-4959
Mailing address
6210 JOHN RYAN DR, STE 109A, FORT WORTH, TX 76132-4113
(817) 294-4959
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
H2308
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DG9427
MEDICARE RR GROUP
TX
01
—
P00463690
MEDICARE RR PTAN
TX
Enumeration date
12/26/2007
Last updated
05/16/2008
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