Provider Demographics
NPI:1891071817
Name:COX, KYLE JAY (ATP)
Entity Type:Individual
Prefix:
First Name:KYLE
Middle Name:JAY
Last Name:COX
Suffix:
Gender:M
Credentials:ATP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6807 WOODWAY DR
Mailing Address - Street 2:B
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76712-6146
Mailing Address - Country:US
Mailing Address - Phone:254-399-0444
Mailing Address - Fax:254-772-0266
Practice Address - Street 1:6807 WOODWAY DR
Practice Address - Street 2:B
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76712-6146
Practice Address - Country:US
Practice Address - Phone:254-399-0444
Practice Address - Fax:254-772-0266
Is Sole Proprietor?:No
Enumeration Date:2011-10-24
Last Update Date:2011-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other