Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LW0102X | Nurse Practitioner - Women's Health | 604115 | TX |
NPI | 1003997818 |
---|---|
Provider Name | Marlo Lucille Cochran |
First Address | Houston, TX 77030-1501 |
Second Address | Houston, TX 77030-3004 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/10/2006 |
Last Update Date | 06/08/2019 |