Provider Demographics
NPI:1356050124
Name:FOX, BILL LEE (RN)
Entity type:Individual
Prefix:
First Name:BILL
Middle Name:LEE
Last Name:FOX
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 E NAVARRO AVE
Mailing Address - Street 2:
Mailing Address - City:MART
Mailing Address - State:TX
Mailing Address - Zip Code:76664-1804
Mailing Address - Country:US
Mailing Address - Phone:254-556-2552
Mailing Address - Fax:
Practice Address - Street 1:1400 E NAVARRO AVE
Practice Address - Street 2:
Practice Address - City:MART
Practice Address - State:TX
Practice Address - Zip Code:76664-1804
Practice Address - Country:US
Practice Address - Phone:254-556-2552
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-21
Last Update Date:2022-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX624639163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX624639OtherTEXAS BOARD OF NURSING