Provider Demographics
NPI:1073787362
Name:FOX, CASEY (AUD)
Entity type:Individual
Prefix:
First Name:CASEY
Middle Name:
Last Name:FOX
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:CASEY
Other - Middle Name:
Other - Last Name:CROW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AUD
Mailing Address - Street 1:714 E KIMBROUGH ST
Mailing Address - Street 2:
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75149-4420
Mailing Address - Country:US
Mailing Address - Phone:972-882-7793
Mailing Address - Fax:
Practice Address - Street 1:714 E KIMBROUGH ST
Practice Address - Street 2:
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75149-4420
Practice Address - Country:US
Practice Address - Phone:972-882-7793
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-17
Last Update Date:2024-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX80279231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist