Basic Information
| Provider Information | |||||||||
| NPI: | 1144607805 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | COCKERILL | ||||||||
| FirstName: | KATHERINE | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7909 FREDERICKSBURG RD STE 110 | ||||||||
| Address2: | |||||||||
| City: | SAN ANTONIO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 782293400 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2106144544 | ||||||||
| FaxNumber: | 2106793724 | ||||||||
| Practice Location | |||||||||
| Address1: | 18915 MEISNER DR | ||||||||
| Address2: | |||||||||
| City: | SAN ANTONIO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 782584223 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2104995158 | ||||||||
| FaxNumber: | 2106793730 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/01/2015 | ||||||||
| LastUpdateDate: | 07/16/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/16/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208800000X | ME129268 | FL | N | Allopathic & Osteopathic Physicians | Urology | 208800000X | S4934 | TX | Y | Allopathic & Osteopathic Physicians | Urology |
No ID Information.