Provider Demographics
NPI:1770703183
Name:COX, HEATHER (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:COX
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1848 LONE STAR RD STE 103
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:TX
Mailing Address - Zip Code:76063-5789
Mailing Address - Country:US
Mailing Address - Phone:817-618-1745
Mailing Address - Fax:817-678-8363
Practice Address - Street 1:1848 LONE STAR RD STE 103
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:TX
Practice Address - Zip Code:76063-5789
Practice Address - Country:US
Practice Address - Phone:817-618-1745
Practice Address - Fax:817-678-8363
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-26
Last Update Date:2022-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSLP1546235Z00000X
WA61229205235Z00000X
TX235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX80T347OtherBLUE CROSS BLUE SHIELD
TX203446401Medicaid
AZ136491OtherAHCCCS ID NUMBER