Provider Demographics
NPI:1316026396
Name:COCHRAN, PHILLIP DOUGLAS (MD)
Entity Type:Individual
Prefix:
First Name:PHILLIP
Middle Name:DOUGLAS
Last Name:COCHRAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4214 ANDREWS HWY STE 306
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79703-4870
Mailing Address - Country:US
Mailing Address - Phone:432-699-6000
Mailing Address - Fax:432-699-6012
Practice Address - Street 1:4214 ANDREWS HWY STE 306
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:TX
Practice Address - Zip Code:79703-4870
Practice Address - Country:US
Practice Address - Phone:432-699-6000
Practice Address - Fax:432-699-6012
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2021-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL0092207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8B2759Medicare ID - Type Unspecified
H24335Medicare UPIN