Provider Demographics
NPI:1881054674
Name:COX, MATTHEW ALLEN (PA-C)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:ALLEN
Last Name:COX
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1130
Mailing Address - Street 2:
Mailing Address - City:DENVER CITY
Mailing Address - State:TX
Mailing Address - Zip Code:79323
Mailing Address - Country:US
Mailing Address - Phone:806-592-2121
Mailing Address - Fax:806-592-5489
Practice Address - Street 1:412 MUSTANG AVENUE
Practice Address - Street 2:
Practice Address - City:DENVER CITY
Practice Address - State:TX
Practice Address - Zip Code:79323
Practice Address - Country:US
Practice Address - Phone:806-592-2121
Practice Address - Fax:806-592-5489
Is Sole Proprietor?:No
Enumeration Date:2016-03-07
Last Update Date:2021-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical