Provider Demographics
NPI:1215764915
Name:COX, TODD JAIME (RRT-ACCS)
Entity type:Individual
Prefix:
First Name:TODD
Middle Name:JAIME
Last Name:COX
Suffix:
Gender:M
Credentials:RRT-ACCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 LAKEWAY DR
Mailing Address - Street 2:
Mailing Address - City:WHITEHOUSE
Mailing Address - State:TX
Mailing Address - Zip Code:75791-5243
Mailing Address - Country:US
Mailing Address - Phone:903-253-1748
Mailing Address - Fax:
Practice Address - Street 1:800 E DAWSON ST FL 4
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75701-2036
Practice Address - Country:US
Practice Address - Phone:903-606-4773
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-17
Last Update Date:2024-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXRCP000570292279C0205X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2279C0205XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredCritical Care