Healthcare Provider Details

I. General information

NPI: 1548443450
Provider Name (Legal Business Name): SHIRLEY COX
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/13/2007
Last Update Date: 09/04/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2504 RIDGE RD SUITE 108
ROCKWALL TX
75087-2569
US

IV. Provider business mailing address

2504 RIDGE RD SUITE 108
ROCKWALL TX
75087-2569
US

V. Phone/Fax

Practice location:
  • Phone: 972-722-4045
  • Fax: 972-722-4087
Mailing address:
  • Phone: 972-722-4045
  • Fax: 972-722-4087

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number0067958
License Number StateTX

VIII. Authorized Official

Name: SHIRLEY COX
Title or Position: OWNER
Credential:
Phone: 972-722-4045