Provider Demographics
NPI:1417990615
Name:COBBS, DAVID LEE (PHD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:LEE
Last Name:COBBS
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:12900 PRESTON RD STE 1015
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75230-1339
Mailing Address - Country:US
Mailing Address - Phone:972-385-0983
Mailing Address - Fax:972-385-0984
Practice Address - Street 1:12900 PRESTON RD STE 1015
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75230-1339
Practice Address - Country:US
Practice Address - Phone:972-385-0983
Practice Address - Fax:972-385-0984
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-14
Last Update Date:2018-01-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX24428103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00K28HMedicare ID - Type UnspecifiedPSYCHOLOGIST
TXR58439Medicare UPIN