Individual
BRIAN COBB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
1000 BLUE BIRD DR STE 5, KILLEEN, TX 76548-1252
(360) 790-1774
(866) 801-2626
Mailing address
PO BOX 10474, AUSTIN, TX 78766-1474
(360) 790-1774
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
54194
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
293343403
—
TX
01
—
564429
MEDICARE
TX
Enumeration date
04/23/2012
Last updated
09/28/2018
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