Provider Demographics
NPI:1770838401
Name:COX, ADAM RANDAL (OD)
Entity type:Individual
Prefix:DR
First Name:ADAM
Middle Name:RANDAL
Last Name:COX
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
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Mailing Address - Street 1:719 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:TX
Mailing Address - Zip Code:75551-3425
Mailing Address - Country:US
Mailing Address - Phone:903-796-8288
Mailing Address - Fax:903-796-9071
Practice Address - Street 1:719 W MAIN ST
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:TX
Practice Address - Zip Code:75551-3425
Practice Address - Country:US
Practice Address - Phone:903-796-8288
Practice Address - Fax:903-796-9071
Is Sole Proprietor?:No
Enumeration Date:2012-07-18
Last Update Date:2012-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8009T152W00000X
TX8009TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist