Provider Demographics
NPI:1114987898
Name:DAWN COCKRELL LM CPM
Entity Type:Organization
Organization Name:DAWN COCKRELL LM CPM
Other - Org Name:WEST TEXAS BIRTH CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:LICENSED MIDWIFE, ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:M
Authorized Official - Last Name:COCKRELL
Authorized Official - Suffix:
Authorized Official - Credentials:LM, CPM
Authorized Official - Phone:432-563-3297
Mailing Address - Street 1:3602 S COUNTY ROAD 1309
Mailing Address - Street 2:
Mailing Address - City:ODESSA
Mailing Address - State:TX
Mailing Address - Zip Code:79765-9656
Mailing Address - Country:US
Mailing Address - Phone:432-563-3297
Mailing Address - Fax:
Practice Address - Street 1:3602 SCR 1309
Practice Address - Street 2:
Practice Address - City:ODESSA
Practice Address - State:TX
Practice Address - Zip Code:79765-9656
Practice Address - Country:US
Practice Address - Phone:432-563-3297
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WEST TEXAS BIRTH SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-03-25
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX01010174400000X, 176B00000X
NM04001R174400000X, 176B00000X
TX02030019176B00000X
TX008332261Q00000X, 261QB0400X, 261QF0050X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes176B00000XOther Service ProvidersMidwifeGroup - Single Specialty
No174400000XOther Service ProvidersSpecialistGroup - Single Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No261QB0400XAmbulatory Health Care FacilitiesClinic/CenterBirthing
No261QF0050XAmbulatory Health Care FacilitiesClinic/CenterFamily Planning, Non-SurgicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX008332OtherLICENSED BIRTHING CENTER
NM04001ROtherPRACTITIONER LICENSE #
TX02030019OtherCPM NUMBER
TX02030019OtherNARM CERTIFIED LICENSE #
TX01010OtherPRACTITIONER LICENSE #
NM04001ROtherLICENSED MIDWIFE
TX008332OtherFACILITY LICENSE NUMBER
TX01010OtherLICENSED MIDWIFE
TX1114987898OtherFACILITY NPI NUMBER