Healthcare Provider Details

I. General information

NPI: 1801073838
Provider Name (Legal Business Name): DERRICK DIONE COX MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/22/2008
Last Update Date: 01/30/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1250 E CLIFF DR SUITE 2A
EL PASO TX
79902-4850
US

IV. Provider business mailing address

1250 E CLIFF DR SUITE 2A
EL PASO TX
79902-4850
US

V. Phone/Fax

Practice location:
  • Phone: 915-577-7951
  • Fax: 915-577-7951
Mailing address:
  • Phone: 915-577-7951
  • Fax: 915-577-7951

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2086X0206X
TaxonomySurgical Oncology Physician
License NumberME110824
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberME110824
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code2086X0206X
TaxonomySurgical Oncology Physician
License NumberP7262
License Number StateTX
# 4
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberP7262
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: