Provider Demographics
NPI:1093717936
Name:COX, NINA JAVIER (OD)
Entity Type:Individual
Prefix:DR
First Name:NINA
Middle Name:JAVIER
Last Name:COX
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9509 AMBERDALE DR
Mailing Address - Street 2:
Mailing Address - City:NORTH CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23236-1256
Mailing Address - Country:US
Mailing Address - Phone:804-745-1922
Mailing Address - Fax:804-249-7347
Practice Address - Street 1:9509 AMBERDALE DR
Practice Address - Street 2:
Practice Address - City:NORTH CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23236-1256
Practice Address - Country:US
Practice Address - Phone:804-745-1922
Practice Address - Fax:804-249-7347
Is Sole Proprietor?:No
Enumeration Date:2005-08-11
Last Update Date:2012-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0618000030152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA9205594Medicaid
VA0129660001Medicare NSC
VA410001040Medicare ID - Type Unspecified
VA9205594Medicaid