Provider Demographics
NPI:1366786519
Name:COX, RANDALL J (PHD)
Entity type:Individual
Prefix:DR
First Name:RANDALL
Middle Name:J
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 1:2524 LILLIAN MILLER PKWY
Mailing Address - Street 2:#110
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76210-7206
Mailing Address - Country:US
Mailing Address - Phone:940-300-1424
Mailing Address - Fax:940-383-2741
Practice Address - Street 1:2524 LILLIAN MILLER PKWY
Practice Address - Street 2:#110
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76210-7206
Practice Address - Country:US
Practice Address - Phone:940-300-1424
Practice Address - Fax:940-383-2741
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-11
Last Update Date:2012-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX25371103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist