Provider Demographics
NPI:1548386949
Name:LOGAN COX INC
Entity type:Organization
Organization Name:LOGAN COX INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:LOGAN
Authorized Official - Last Name:COX
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:432-550-2830
Mailing Address - Street 1:4692 E UNIVERSITY BLVD
Mailing Address - Street 2:SUITE 105
Mailing Address - City:ODESSA
Mailing Address - State:TX
Mailing Address - Zip Code:79762-6155
Mailing Address - Country:US
Mailing Address - Phone:432-550-2830
Mailing Address - Fax:432-363-0989
Practice Address - Street 1:4692 E UNIVERSITY BLVD
Practice Address - Street 2:SUITE 105
Practice Address - City:ODESSA
Practice Address - State:TX
Practice Address - Zip Code:79762-6155
Practice Address - Country:US
Practice Address - Phone:432-550-2830
Practice Address - Fax:432-363-0989
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-21
Last Update Date:2010-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXTX2925111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX001184301Medicaid
TX88344ZOtherBCBS
TX601210Medicare PIN
TX88344ZOtherBCBS
TX0A5359Medicare PIN