| Brett L. Cochrum, Md, Pa | |
|
6210 John Ryan Dr Ste 109a Fort Worth TX 76132-4113 | |
| (817) 294-4959 | |
| Not Available |
| Full Name | Brett L. Cochrum, Md, Pa |
|---|---|
| Speciality | Family Medicine |
| Location | 6210 John Ryan Dr, Fort Worth, Texas |
| Authorized Official Name and Position | Brett Landon Cochrum (OWNER) |
| Authorized Official Contact | 8172944959 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Brett L. Cochrum, Md, Pa 6210 John Ryan Dr Ste 109a Fort Worth TX 76132-4113 Ph: (817) 294-4959 | Brett L. Cochrum, Md, Pa 6210 John Ryan Dr Ste 109a Fort Worth TX 76132-4113 Ph: (817) 294-4959 |
| NPI Number | 1619151727 |
|---|---|
| Provider Enumeration Date | 12/26/2007 |
| Last Update Date | 05/16/2008 |
| Medicare PECOS PAC ID | 4981785961 |
|---|---|
| Medicare Enrollment ID | O20080116000081 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619151727 | NPI | - | NPPES |
| DG9427 | Other | TX | MEDICARE RR GROUP |
| P00463690 | Other | TX | MEDICARE RR PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | H2308 (Texas) | Primary |
| Provider Name | Fred W Rohm |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1407894926 PECOS PAC ID: 1850312521 Enrollment ID: I20051208000879 |
| Provider Name | Brett L Cochrum |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1801836028 PECOS PAC ID: 0446331425 Enrollment ID: I20080116000077 |
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