Healthcare Provider Details

I. General information

NPI: 1669552444
Provider Name (Legal Business Name): WILLIAM CURTIS COGBURN D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/16/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1724 B I 35 E
PEARSALL TX
78061
US

IV. Provider business mailing address

1724 B I 35 E
PEARSALL TX
78061
US

V. Phone/Fax

Practice location:
  • Phone: 830-334-4006
  • Fax: 830-334-4238
Mailing address:
  • Phone: 830-334-4006
  • Fax: 830-334-4238

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NN0400X
TaxonomyNeurology Chiropractor
License Number5952
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: