Provider Demographics
NPI:1699787838
Name:COCHRANE, TERANCE ALLEN
Entity type:Individual
Prefix:
First Name:TERANCE
Middle Name:ALLEN
Last Name:COCHRANE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9730 S MCCARRAN BLVD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89523-9203
Mailing Address - Country:US
Mailing Address - Phone:775-787-3939
Mailing Address - Fax:775-746-3991
Practice Address - Street 1:9730 S MCCARRAN BLVD
Practice Address - Street 2:SUITE 1
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89523-9203
Practice Address - Country:US
Practice Address - Phone:775-787-3939
Practice Address - Fax:775-746-3991
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-13
Last Update Date:2017-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVNV221152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVV103695Medicare PIN
NVT81845Medicare UPIN
NV2358100001Medicare NSC