Provider Demographics
NPI:1548289028
Name:COX, ANNA CHRISTINE (PHYSICIAN'S ASSISTAN)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:CHRISTINE
Last Name:COX
Suffix:
Gender:F
Credentials:PHYSICIAN'S ASSISTAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1517 10TH ST
Mailing Address - Street 2:
Mailing Address - City:WICHITA FALLS
Mailing Address - State:TX
Mailing Address - Zip Code:76301-4404
Mailing Address - Country:US
Mailing Address - Phone:940-322-1411
Mailing Address - Fax:940-322-2120
Practice Address - Street 1:1517 10TH ST
Practice Address - Street 2:
Practice Address - City:WICHITA FALLS
Practice Address - State:TX
Practice Address - Zip Code:76301-4404
Practice Address - Country:US
Practice Address - Phone:940-322-1411
Practice Address - Fax:940-322-2120
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2019-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA03963363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant