Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | AP138512 | TX |
NPI | 1124508627 |
---|---|
Provider Name | Mr. Joshua Samuel Cox |
First Address | Dallas, TX 75373-2973 |
Second Address | Fort Worth, TX 76104-4917 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/08/2018 |
Last Update Date | 10/10/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
104420703 | NATIONAL CERTIFICATION CORPORATION (01) | |
AP138512 | TEXAS BOARD OF NURSING APRN (01) | TX |