Provider Demographics
NPI:1114034584
Name:FOX, WILLIAM T JR (PA-C)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:T
Last Name:FOX
Suffix:JR
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3003 BEE CAVES RD STE 201
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78746-5550
Mailing Address - Country:US
Mailing Address - Phone:512-314-3910
Mailing Address - Fax:512-524-6008
Practice Address - Street 1:3003 BEE CAVES RD STE 201
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78746-5550
Practice Address - Country:US
Practice Address - Phone:512-314-3910
Practice Address - Fax:512-524-6008
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA01973363AS0400X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX210319402Medicaid
TX8F22289Medicare PIN