Provider Demographics
NPI:1174842066
Name:CENTER FOR PELVIC HEALTH
Entity Type:Organization
Organization Name:CENTER FOR PELVIC HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:CLIFTON
Authorized Official - Middle Name:L
Authorized Official - Last Name:COX
Authorized Official - Suffix:II
Authorized Official - Credentials:MD
Authorized Official - Phone:817-488-2707
Mailing Address - Street 1:1100 E SOUTHLAKE BLVD
Mailing Address - Street 2:SUITE 250
Mailing Address - City:SOUTHLAKE
Mailing Address - State:TX
Mailing Address - Zip Code:76092-6357
Mailing Address - Country:US
Mailing Address - Phone:817-488-2707
Mailing Address - Fax:817-488-2549
Practice Address - Street 1:1100 E SOUTHLAKE BLVD
Practice Address - Street 2:SUITE 250
Practice Address - City:SOUTHLAKE
Practice Address - State:TX
Practice Address - Zip Code:76092-6357
Practice Address - Country:US
Practice Address - Phone:817-488-2707
Practice Address - Fax:817-488-2549
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-18
Last Update Date:2010-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ0814225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty