Provider Demographics
NPI:1952361016
Name:KOCKS, JOE D JR (MD)
Entity Type:Individual
Prefix:
First Name:JOE
Middle Name:D
Last Name:KOCKS
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:8140 N MOPAC EXPY
Mailing Address - Street 2:SUITE 3-210
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78759-8837
Mailing Address - Country:US
Mailing Address - Phone:512-493-9227
Mailing Address - Fax:512-343-2745
Practice Address - Street 1:8140 N MOPAC EXPY
Practice Address - Street 2:SUITE 3-210
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-8837
Practice Address - Country:US
Practice Address - Phone:512-493-9227
Practice Address - Fax:512-343-2745
Is Sole Proprietor?:No
Enumeration Date:2006-03-24
Last Update Date:2010-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ0846207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1233934-02Medicaid
TX82X374Medicare ID - Type Unspecified
TXF27292Medicare UPIN