Provider Demographics
NPI:1497718852
Name:KNOX, SALLY M (MD)
Entity Type:Individual
Prefix:DR
First Name:SALLY
Middle Name:M
Last Name:KNOX
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 911230
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75391-1230
Mailing Address - Country:US
Mailing Address - Phone:972-997-8000
Mailing Address - Fax:972-234-0813
Practice Address - Street 1:3410 WORTH ST
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75246-2044
Practice Address - Country:US
Practice Address - Phone:214-370-1000
Practice Address - Fax:214-370-1202
Is Sole Proprietor?:No
Enumeration Date:2006-04-07
Last Update Date:2015-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF69732086X0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX099779302Medicaid
TXP00889685OtherRAILROAD MEDICARE
TX099779303Medicaid
TX099779304Medicaid
TX391964YKYCMedicare PIN
TX099779304Medicaid
TX099779302Medicaid