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NPI Code Detail

MEDICARE: DR. BRIAN THOMAS COCKE MD

MEDICARE: DR. BRIAN THOMAS COCKE MD
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
1207Q00000XFamily Medicine Physician01063055AIN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11134272479OTHERINVETERANS ADMINISTRATION

General Provider Information

NPI Number : 1134272479
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. BRIAN THOMAS COCKE MD
Provider Business Mailing Address
First Line : 2212 ROCK CREEK DR
Second Line :
City : KERRVILLE
State : TX
Zip : 78028-6502
Country : US
Telephone Number : 979-446-9829
Fax Number :
Provider Business Practice Location Address
First Line : 3600 MEMORIAL BLVD
Second Line :
City : KERRVILLE
State : TX
Zip : 78028-5819
Country : US
Telephone Number : 830-792-2581
Fax Number : 830-792-2473
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/19/2007
Last Update Date : 10/21/2019

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