MEDICARE: GLENDA COX RN

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	163W00000X	Registered Nurse	628835	TX

General Provider Information

NPI Number	:	1235462243
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GLENDA COX RN

Provider Business Mailing Address
First Line	:	PO BOX 678696
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75267-8696
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3414 MILTON AVE
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75205-1338
Country	:	US
Telephone Number	:	214-217-1911
Fax Number	:

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

Provider Enumeration Date	:	09/09/2009
Last Update Date	:	09/09/2009

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Directions to “ GLENDA COX RN” Practice Location

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