Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2086S0102X | Surgical Critical Care | H6136 | TX |
Y | 2086S0120X | Pediatric Surgery | H6136 | TX |
NPI | 1558391623 |
---|---|
Provider Name | Dr. Charles Samuel Cox JR. |
First Address | Houston, TX 77030-1501 |
Second Address | Houston, TX 77030-3000 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/07/2006 |
Last Update Date | 06/11/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
136926601 | CSHCN (01) | |
136926607 | (05) | TX |
136926610 | (05) | TX |
81Z197 | BCBSTX (01) | TX |
E95892 | (02) |