Provider Demographics
NPI:1114967833
Name:COX, MIKE B (DC)
Entity Type:Individual
Prefix:DR
First Name:MIKE
Middle Name:B
Last Name:COX
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6021 WALKER BLVD
Mailing Address - Street 2:SUITE # 111
Mailing Address - City:NORTH RICHLAND HILLS
Mailing Address - State:TX
Mailing Address - Zip Code:76180-0902
Mailing Address - Country:US
Mailing Address - Phone:817-889-6277
Mailing Address - Fax:
Practice Address - Street 1:6021 WALKER BLVD
Practice Address - Street 2:SUITE # 111
Practice Address - City:NORTH RICHLAND HILLS
Practice Address - State:TX
Practice Address - Zip Code:76180-0902
Practice Address - Country:US
Practice Address - Phone:817-889-6277
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-08
Last Update Date:2016-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7396111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX7396OtherTEXAS LICENSE #-TAX EXEMPT NUMBER
TX75-2753427OtherTAX ID #
TX7396OtherTEXAS LICENSE #-TAX EXEMPT NUMBER
TXU74860Medicare UPIN