Provider Demographics
NPI:1528214921
Name:COX, LACEY BETH (PHARMD)
Entity Type:Individual
Prefix:MS
First Name:LACEY
Middle Name:BETH
Last Name:COX
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3070 N. GOLIAD
Mailing Address - Street 2:TOM THUMB PHARMACY #2964
Mailing Address - City:ROCKWALL
Mailing Address - State:TX
Mailing Address - Zip Code:75087
Mailing Address - Country:US
Mailing Address - Phone:972-961-9335
Mailing Address - Fax:972-961-9334
Practice Address - Street 1:3070 N. GOLIAD
Practice Address - Street 2:TOM THUMB PHARMACY #2964
Practice Address - City:ROCKWALL
Practice Address - State:TX
Practice Address - Zip Code:75087
Practice Address - Country:US
Practice Address - Phone:972-961-9335
Practice Address - Fax:972-961-9334
Is Sole Proprietor?:No
Enumeration Date:2008-08-18
Last Update Date:2010-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX46491183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist