Provider Demographics
NPI:1134272479
Name:COCKE, BRIAN THOMAS (MD)
Entity type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:THOMAS
Last Name:COCKE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2212 ROCK CREEK DR
Mailing Address - Street 2:
Mailing Address - City:KERRVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78028-6502
Mailing Address - Country:US
Mailing Address - Phone:979-446-9829
Mailing Address - Fax:
Practice Address - Street 1:3600 MEMORIAL BLVD
Practice Address - Street 2:
Practice Address - City:KERRVILLE
Practice Address - State:TX
Practice Address - Zip Code:78028-5819
Practice Address - Country:US
Practice Address - Phone:830-792-2581
Practice Address - Fax:830-792-2473
Is Sole Proprietor?:No
Enumeration Date:2007-01-19
Last Update Date:2019-10-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN01063055A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN1134272479OtherVETERANS ADMINISTRATION