Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111N00000X | Chiropractor | 4327 | TX |
Y | 111NR0400X | Rehabilitation Chiropractor | 4327 | TX |
NPI | 1386800373 |
---|---|
Provider Name | Dr. Jeffry Dobbs Cockerell |
First Address | Houston, TX 77059-4402 |
Second Address | The Woodlands, TX 77384-4000 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/07/2008 |
Last Update Date | 20/03/2012 |