Provider Demographics
NPI:1124583562
Name:COX, BRIAN MATTHEW (COTA)
Entity type:Individual
Prefix:MR
First Name:BRIAN
Middle Name:MATTHEW
Last Name:COX
Suffix:
Gender:M
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19503 CABRA CT
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77449-7302
Mailing Address - Country:US
Mailing Address - Phone:832-314-8967
Mailing Address - Fax:
Practice Address - Street 1:16000 PARK TEN PL STE 204
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77084-7296
Practice Address - Country:US
Practice Address - Phone:832-321-4728
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-08
Last Update Date:2019-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX215455224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant