Provider Demographics
NPI:1144514480
Name:COX, ANDREA
Entity type:Individual
Prefix:MRS
First Name:ANDREA
Middle Name:
Last Name:COX
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20777 HIGHWAY 59 N
Mailing Address - Street 2:T-1457
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77338-2209
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:20777 HIGHWAY 59 N
Practice Address - Street 2:T-1457
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77338-2209
Practice Address - Country:US
Practice Address - Phone:281-540-2126
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-03
Last Update Date:2011-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX44279183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist