Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | P0187 | TX |
NPI | 1003044058 |
---|---|
Provider Name | Dr. Charles Derek Cohn |
First Address | Fredericksburg, TX 78624-5022 |
Second Address | Fredericksburg, TX 78624-5022 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/06/2009 |
Last Update Date | 29/04/2015 |