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NPI Code Detail

MEDICARE: KHIYA COCKERHAM

MEDICARE: KHIYA COCKERHAM
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1224Z00000XOccupational Therapy Assistant219138TX

General Provider Information

NPI Number : 1639011364
Entity Type Code : Individual
Provider Name (Legal Business Name) : KHIYA COCKERHAM
Provider Business Mailing Address
First Line : 12770 COIT RD STE 870
Second Line :
City : DALLAS
State : TX
Zip : 75251-1455
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 12770 COIT RD STE 870
Second Line :
City : DALLAS
State : TX
Zip : 75251-1455
Country : US
Telephone Number : 972-756-0500
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/09/2026
Last Update Date : 04/09/2026

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Directions to “ KHIYA COCKERHAM ” Practice Location

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