Healthcare Provider Details

I. General information

NPI: 1306764287
Provider Name (Legal Business Name): RICHARD COX III PTA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/08/2026
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1382 S COTTON LN
GOODYEAR AZ
85338-4657
US

IV. Provider business mailing address

11340 W BELL RD
SURPRISE AZ
85378-9342
US

V. Phone/Fax

Practice location:
  • Phone: 520-438-7090
  • Fax:
Mailing address:
  • Phone: 623-226-6644
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License NumberPTA-015102
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: