1114987898 NPI number — DAWN COCKRELL LM CPM

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1114987898 NPI number — DAWN COCKRELL LM CPM

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DAWN COCKRELL LM CPM
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1114987898
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/06/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3602 S COUNTY ROAD 1309
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ODESSA
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
79765-9656
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
432-563-3297
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3602 SCR 1309
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ODESSA
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
79765-9656
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
432-563-3297
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/25/2006

Additional Information

Authorized Official

Authorized Official Last Name:
COCKRELL
Authorized Official First Name:
DAWN
Authorized Official Middle Name:
M.
Authorized Official Title or Position:
LICENSED MIDWIFE, ADMINISTRATOR
Authorized Official Telephone Number:
432-563-3297

Provider Taxonomy Codes

  • Taxonomy code: 174400000X , with the licence number:  01010 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 174400000X , with the licence number: 04001R , registered in the state of NM ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 176B00000X , with the licence number: 01010 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 176B00000X , with the licence number: 02030019 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 176B00000X , with the licence number: 04001R , registered in the state of NM ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261Q00000X , with the licence number: 008332 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QB0400X , with the licence number: 008332 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QF0050X , with the licence number: 008332 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 008332 . This is a "LICENSED BIRTHING CENTER" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 04001R . This is a "PRACTITIONER LICENSE #" identifier , issued by the state of ( NM ) . This identifiers is of the category "OTHER".
  • Identifier: 02030019 . This is a "CPM NUMBER" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 02030019 . This is a "NARM CERTIFIED LICENSE #" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 01010 . This is a "PRACTITIONER LICENSE #" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 04001R . This is a "LICENSED MIDWIFE" identifier , issued by the state of ( NM ) . This identifiers is of the category "OTHER".
  • Identifier: 008332 . This is a "FACILITY LICENSE NUMBER" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 01010 . This is a "LICENSED MIDWIFE" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 1114987898 . This is a "FACILITY NPI NUMBER" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com