Provider Demographics
NPI:1790771483
Name:COX, CONALD W JR (MD)
Entity Type:Individual
Prefix:
First Name:CONALD
Middle Name:W
Last Name:COX
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:1150 N 18TH ST
Mailing Address - Street 2:SUITE 203
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79601-2948
Mailing Address - Country:US
Mailing Address - Phone:325-673-4757
Mailing Address - Fax:325-673-1626
Practice Address - Street 1:1150 N 18TH ST
Practice Address - Street 2:SUITE 203
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79601-2948
Practice Address - Country:US
Practice Address - Phone:325-673-4757
Practice Address - Fax:325-673-1626
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-27
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXE6292207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXA003OtherTRICARE
C14845Medicare UPIN
TX87A347Medicare ID - Type Unspecified