Provider Demographics
NPI:1710370168
Name:COCKBURN, DANIELLE (DC)
Entity Type:Individual
Prefix:DR
First Name:DANIELLE
Middle Name:
Last Name:COCKBURN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23561 HICKORY DR
Mailing Address - Street 2:
Mailing Address - City:PORTER
Mailing Address - State:TX
Mailing Address - Zip Code:77365-5217
Mailing Address - Country:US
Mailing Address - Phone:281-740-9225
Mailing Address - Fax:
Practice Address - Street 1:4665 SOUTHWEST FWY
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77027-7213
Practice Address - Country:US
Practice Address - Phone:713-528-4200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-10
Last Update Date:2015-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12880111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor