Basic Information
| Provider Information | |||||||||
| NPI: | 1710920269 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | COCHRAN | ||||||||
| FirstName: | ERNEST | ||||||||
| MiddleName: | WINSTON | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | JR. | ||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 911230 | ||||||||
| Address2: | |||||||||
| City: | DALLAS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 753911230 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9729978000 | ||||||||
| FaxNumber: | 9724379605 | ||||||||
| Practice Location | |||||||||
| Address1: | 3550 NE LOOP 286 | ||||||||
| Address2: | |||||||||
| City: | PARIS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 754605004 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9037850031 | ||||||||
| FaxNumber: | 9034846755 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/13/2006 | ||||||||
| LastUpdateDate: | 12/12/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RX0202X | F1460 | TX | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Medical Oncology |
ID Information
| ID | Type | State | Issuer | Description | 830000144 | 01 | TX | RAILROAD | OTHER | 100153600A | 05 | OK | MEDICAID | 8R1412 | 01 | TX | BLUE CROSS OF TEXAS | OTHER | 132529202 | 05 | TX | MEDICAID |