Provider Demographics
NPI:1609065986
Name:COX, ANGELA BROOKE (DC)
Entity Type:Individual
Prefix:DR
First Name:ANGELA
Middle Name:BROOKE
Last Name:COX
Suffix:
Gender:F
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:PO BOX 865
Mailing Address - Street 2:
Mailing Address - City:GLADEWATER
Mailing Address - State:TX
Mailing Address - Zip Code:75647-0865
Mailing Address - Country:US
Mailing Address - Phone:903-946-2150
Mailing Address - Fax:
Practice Address - Street 1:112 N LEE DR
Practice Address - Street 2:
Practice Address - City:GLADEWATER
Practice Address - State:TX
Practice Address - Zip Code:75647-2509
Practice Address - Country:US
Practice Address - Phone:903-374-2535
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-23
Last Update Date:2016-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10744111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX608422OtherBCBS
TX613102Medicare PIN