Provider Demographics
NPI:1992923346
Name:COCO, ELDA LANE (PHD)
Entity type:Individual
Prefix:DR
First Name:ELDA
Middle Name:LANE
Last Name:COCO
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27530 GOLF VIEW LN
Mailing Address - Street 2:
Mailing Address - City:HUFFMAN
Mailing Address - State:TX
Mailing Address - Zip Code:77336-3745
Mailing Address - Country:US
Mailing Address - Phone:281-324-2163
Mailing Address - Fax:
Practice Address - Street 1:4950 MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77007-7440
Practice Address - Country:US
Practice Address - Phone:713-802-7745
Practice Address - Fax:713-802-7640
Is Sole Proprietor?:No
Enumeration Date:2007-04-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXS001621041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical