Provider Demographics
NPI:1730184490
Name:COX, CHARLES LEONARD (PHD)
Entity type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:LEONARD
Last Name:COX
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:77 SUGAR CREEK CENTER BLVD
Mailing Address - Street 2:STE 375
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-3789
Mailing Address - Country:US
Mailing Address - Phone:281-265-4566
Mailing Address - Fax:281-265-5127
Practice Address - Street 1:50 SUGAR CREEK CENTER BLVD
Practice Address - Street 2:STE 250
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-3544
Practice Address - Country:US
Practice Address - Phone:281-265-4566
Practice Address - Fax:281-265-5127
Is Sole Proprietor?:No
Enumeration Date:2005-06-17
Last Update Date:2019-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX21701103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX87357AOtherBCBS PROVIDER NUMBER
TX00JM85OtherBLUECROSS BLUESHIELD NUMB
TX00JM85OtherBLUECROSS BLUESHIELD NUMB