Provider Demographics
NPI:1639172232
Name:COX, DHANA R (MD)
Entity Type:Individual
Prefix:DR
First Name:DHANA
Middle Name:R
Last Name:COX
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:DHANA
Other - Middle Name:R
Other - Last Name:BAGGETT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:911 23RD ST
Mailing Address - Street 2:
Mailing Address - City:CANYON
Mailing Address - State:TX
Mailing Address - Zip Code:79015-4645
Mailing Address - Country:US
Mailing Address - Phone:806-655-2104
Mailing Address - Fax:806-655-0522
Practice Address - Street 1:2701 S GEORGIA ST
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79109-1979
Practice Address - Country:US
Practice Address - Phone:806-350-3000
Practice Address - Fax:806-350-3337
Is Sole Proprietor?:No
Enumeration Date:2005-05-27
Last Update Date:2018-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK2882207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX158112603Medicaid
TX158112603Medicaid
TXH03690Medicare UPIN
TX8K1578Medicare PIN