Provider Demographics
NPI:1477743284
Name:COCHERAN FAMILY EYE CARE LLC
Entity Type:Organization
Organization Name:COCHERAN FAMILY EYE CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED AGENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JUSTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:COCHERAN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:405-326-3942
Mailing Address - Street 1:802 W PETREE RD
Mailing Address - Street 2:
Mailing Address - City:ANADARKO
Mailing Address - State:OK
Mailing Address - Zip Code:73005-6026
Mailing Address - Country:US
Mailing Address - Phone:405-247-3937
Mailing Address - Fax:
Practice Address - Street 1:802 W PETREE RD
Practice Address - Street 2:
Practice Address - City:ANADARKO
Practice Address - State:OK
Practice Address - Zip Code:73005-6026
Practice Address - Country:US
Practice Address - Phone:405-247-3937
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-27
Last Update Date:2007-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2518152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty