Provider Demographics
NPI:1831587344
Name:COCHRANE, GLENN EUGENE (CRNA)
Entity type:Individual
Prefix:MR
First Name:GLENN
Middle Name:EUGENE
Last Name:COCHRANE
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3930 NAAMAN SCHOOL RD STE B
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75040-0967
Mailing Address - Country:US
Mailing Address - Phone:530-300-3852
Mailing Address - Fax:972-619-0069
Practice Address - Street 1:3930 NAAMAN SCHOOL RD STE B
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75040-0967
Practice Address - Country:US
Practice Address - Phone:903-342-5227
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-01-06
Last Update Date:2023-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP127221367500000X
CA95000256367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered