Individual
CHERYL LANDRY KOKKINIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
1101 KELLER PKWY, KELLER, TX 76248-3614
(817) 562-3111
(817) 562-3114
Mailing address
1101 KELLER PKWY, KELLER, TX 76248-3614
(817) 562-3111
(817) 562-3114
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
108262
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8T1922
BCBS PROVIDER NUMBER
TX
Enumeration date
02/06/2007
Last updated
11/24/2013
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