MEDICARE: DR. MIKE B COX D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111NS0005X	Sports Physician Chiropractor	7396	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	7396	OTHER	TX	TEXAS LICENSE #-TAX EXEMPT NUMBER
2	75-2753427	OTHER	TX	TAX ID #

General Provider Information

NPI Number	:	1114967833
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MIKE B COX D.C.

Provider Business Mailing Address
First Line	:	6021 WALKER BLVD
Second Line	:	SUITE # 111
City	:	NORTH RICHLAND HILLS
State	:	TX
Zip	:	76180-0902
Country	:	US
Telephone Number	:	817-889-6277
Fax Number	:

Provider Business Practice Location Address
First Line	:	6021 WALKER BLVD
Second Line	:	SUITE # 111
City	:	NORTH RICHLAND HILLS
State	:	TX
Zip	:	76180-0902
Country	:	US
Telephone Number	:	817-889-6277
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/08/2006
Last Update Date	:	09/23/2016

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