Provider Demographics
NPI:1083144240
Name:COCHRAN, MARK DOUGLAS
Entity Type:Individual
Prefix:MR
First Name:MARK
Middle Name:DOUGLAS
Last Name:COCHRAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2030 NAPLECHASE CREST DR
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77373-2002
Mailing Address - Country:US
Mailing Address - Phone:832-823-4576
Mailing Address - Fax:
Practice Address - Street 1:8118 FRY RD STE 203
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77433-7851
Practice Address - Country:US
Practice Address - Phone:281-377-3743
Practice Address - Fax:713-904-2417
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-19
Last Update Date:2023-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX204050106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist