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NPI Code Detail

MEDICARE: CAROLYN COLETTE COCHRAN RD,LD,MS,CDE

MEDICARE: CAROLYN COLETTE COCHRAN RD,LD,MS,CDE
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
1133VN1005XRenal Nutrition Registered DietitianDT00622TX
2133V00000XRegistered DietitianDT00622TX

General Provider Information

NPI Number : 1174636401
Entity Type Code : Individual
Provider Name (Legal Business Name) : CAROLYN COLETTE COCHRAN RD,LD,MS,CDE
Provider Business Mailing Address
First Line : 1505 LBJ FWY STE 700
Second Line :
City : DALLAS
State : TX
Zip : 75234-6065
Country : US
Telephone Number : 214-358-2300
Fax Number : 214-579-6941
Provider Business Practice Location Address
First Line : 3604 LIVE OAK ST
Second Line : SUITE 100
City : DALLAS
State : TX
Zip : 75204-6168
Country : US
Telephone Number : 214-358-2300
Fax Number : 214-366-6330
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/17/2006
Last Update Date : 06/12/2025

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Directions to “ CAROLYN COLETTE COCHRAN RD,LD,MS,CDE” Practice Location

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