Jack Taylor Cockburn, PHD is a
Psychologist - Counseling based in Lewisville, Texas. Jack Taylor Cockburn is licensed to practice in Texas (license number 14096) and his current practice location is
131 Degan, #103, Lewisville, Texas. He can be reached at his office (for appointments etc.) via phone at
(972) 436-8881.
NPI number for Jack Taylor Cockburn is 1972690303 and his current mailing address is 131 Degan, #103, Lewisville, Texas. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1972690303.
Healthcare Provider's Profile
| Full Name | Jack Taylor Cockburn |
|---|
| Gender | Male |
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| Speciality | Psychologist - Counseling |
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| Location | 131 Degan, Lewisville, Texas |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1972690303
- Provider Enumeration Date: 10/06/2006
- Last Update Date: 08/26/2008
Medical Identifiers
Medical identifiers for Jack Taylor Cockburn such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1972690303 | NPI | - | NPPES |
| 028530601 | Medicaid | TX | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YP2500X | Counselor - Professional | 14096 (Texas) | Secondary |
| 103TC1900X | Psychologist - Counseling | 14096 (Texas) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Jack Taylor Cockburn is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Jack Taylor Cockburn, PHD
131 Degan, #103,
Lewisville, TX 75057
Ph: (972) 436-8881 | Jack Taylor Cockburn, PHD
131 Degan, #103,
Lewisville, TX 75057
Ph: (972) 436-8881 |
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