Healthcare Provider Details

I. General information

NPI: 1275618696
Provider Name (Legal Business Name): IVOR W FOOX MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/25/2006
Last Update Date: 12/11/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9055 KATY FWY STE 200
HOUSTON TX
77024-1629
US

IV. Provider business mailing address

4524 HIGHWAY 6 N
HOUSTON TX
77084-3402
US

V. Phone/Fax

Practice location:
  • Phone: 713-461-2915
  • Fax: 713-461-5307
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberE7922
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: