Healthcare Provider Details

I. General information

NPI: 1295648343
Provider Name (Legal Business Name): AMY SULIANO COX
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/28/2026
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

704 FAIRWAY OAKS
CONROE TX
77302-3841
US

IV. Provider business mailing address

704 FAIRWAY OAKS
CONROE TX
77302-3841
US

V. Phone/Fax

Practice location:
  • Phone: 936-760-1880
  • Fax:
Mailing address:
  • Phone: 936-760-1880
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number100755
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: