MEDICARE: DR. MICHAEL RAY KNOX PH.D.

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
1	103TC0700X	Clinical Psychologist	PHD33015TX	TX
2	103G00000X	Clinical Neuropsychologist	33015	TX

General Provider Information

NPI Number	:	1275598955
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL RAY KNOX PH.D.

Provider Business Mailing Address
First Line	:	9200 NEW TRAILS DR
Second Line	:	SUITE 100
City	:	THE WOODLANDS
State	:	TX
Zip	:	77381-5256
Country	:	US
Telephone Number	:	281-364-9509
Fax Number	:	281-364-0984

Provider Business Practice Location Address
First Line	:	9200 NEW TRAILS DR
Second Line	:	SUITE 100
City	:	THE WOODLANDS
State	:	TX
Zip	:	77381-5256
Country	:	US
Telephone Number	:	281-364-9509
Fax Number	:	281-364-0984

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/18/2006
Last Update Date	:	05/31/2023

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