Individual
BRETT COCHRUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6108 OAKBEND TRL STE 102, FORT WORTH, TX 76132-3917
(817) 294-4959
(817) 294-1324
Mailing address
6108 OAKBEND TRL STE 102, FORT WORTH, TX 76132-3917
(817) 294-4959
(817) 294-1324
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
H2308
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
133752906
—
TX
01
—
45D1072789
CLIA
—
01
—
DG9427
MEDICARE RR GROUP
TX
01
—
P00463690
MEDICARE RR PTAN
TX
Enumeration date
06/07/2006
Last updated
04/20/2020
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