Provider Demographics
NPI:1811010952
Name:CLIFTON L. COX II M D P A
Entity Type:Organization
Organization Name:CLIFTON L. COX II M D P A
Other - Org Name:COPE CENTER FOR COLORECTAL & PELVIC HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CLIFTON
Authorized Official - Middle Name:L
Authorized Official - Last Name:COX
Authorized Official - Suffix:II
Authorized Official - Credentials:M D
Authorized Official - Phone:817-410-7777
Mailing Address - Street 1:300 S. NOLEN DR.
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SOUTHLAKE
Mailing Address - State:TX
Mailing Address - Zip Code:76092-8057
Mailing Address - Country:US
Mailing Address - Phone:817-410-7777
Mailing Address - Fax:817-410-9906
Practice Address - Street 1:300 S. NOLEN DR.
Practice Address - Street 2:SUITE 100
Practice Address - City:SOUTHLAKE
Practice Address - State:TX
Practice Address - Zip Code:76092
Practice Address - Country:US
Practice Address - Phone:817-410-7777
Practice Address - Fax:817-410-9906
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-06
Last Update Date:2014-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ0814174400000X, 208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal SurgeryGroup - Multi-Specialty
No174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00061ZMedicare PIN