Provider Demographics
NPI:1457925950
Name:COX, VANESSA RENEE (COTA)
Entity Type:Individual
Prefix:
First Name:VANESSA
Middle Name:RENEE
Last Name:COX
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:265 DEERPARK DR
Mailing Address - Street 2:
Mailing Address - City:WASKOM
Mailing Address - State:TX
Mailing Address - Zip Code:75692-4009
Mailing Address - Country:US
Mailing Address - Phone:903-407-5906
Mailing Address - Fax:
Practice Address - Street 1:265 DEERPARK DR
Practice Address - Street 2:
Practice Address - City:WASKOM
Practice Address - State:TX
Practice Address - Zip Code:75692-4009
Practice Address - Country:US
Practice Address - Phone:903-407-5906
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-18
Last Update Date:2021-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX215955224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant