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NPI Code Detail

MEDICARE: NIKKI SHANDELL FOX DO

MEDICARE: NIKKI SHANDELL FOX DO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208100000XPhysical Medicine & Rehabilitation Physician51010179876MI
2208VP0000XPain Medicine PhysicianP8131TX

General Provider Information

NPI Number : 1033424932
Entity Type Code : Individual
Provider Name (Legal Business Name) : NIKKI SHANDELL FOX DO
Provider Business Mailing Address
First Line : 7235 BOAT CLUB RD
Second Line :
City : FORT WORTH
State : TX
Zip : 76179-4555
Country : US
Telephone Number : 817-677-9535
Fax Number : 817-677-9536
Provider Business Practice Location Address
First Line : 7235 BOAT CLUB RD
Second Line :
City : FT WORTH
State : TX
Zip : 76179-4555
Country : US
Telephone Number : 817-677-9535
Fax Number : 817-677-9536
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/16/2010
Last Update Date : 09/27/2021

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Directions to “ NIKKI SHANDELL FOX DO” Practice Location

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