Provider Demographics
NPI:1154304467
Name:COCHRAN, JAMES MICHAEL (MD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:MICHAEL
Last Name:COCHRAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 459
Mailing Address - Street 2:
Mailing Address - City:GROVETON
Mailing Address - State:TX
Mailing Address - Zip Code:75845-0459
Mailing Address - Country:US
Mailing Address - Phone:936-642-0841
Mailing Address - Fax:936-309-0086
Practice Address - Street 1:180 MAGEE LN
Practice Address - Street 2:
Practice Address - City:GROVETON
Practice Address - State:TX
Practice Address - Zip Code:75845-4185
Practice Address - Country:US
Practice Address - Phone:936-642-0841
Practice Address - Fax:936-093-0086
Is Sole Proprietor?:No
Enumeration Date:2005-11-22
Last Update Date:2022-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH4891207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX158535801Medicaid
E02299Medicare UPIN
TX158535801Medicaid