Provider Demographics
NPI:1427097724
Name:FOX, ROBERT JOHN JR (MD)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:JOHN
Last Name:FOX
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:3807 SPICEWOOD SPRINGS RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78759-8965
Mailing Address - Country:US
Mailing Address - Phone:512-476-9195
Mailing Address - Fax:512-476-2857
Practice Address - Street 1:3807 SPICEWOOD SPRINGS RD
Practice Address - Street 2:SUITE 200
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-8965
Practice Address - Country:US
Practice Address - Phone:512-476-9195
Practice Address - Fax:512-476-2857
Is Sole Proprietor?:No
Enumeration Date:2006-06-05
Last Update Date:2017-08-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXE5753207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8A1844Medicare PIN
TXC15690Medicare UPIN
TXE5753OtherMEDICAL LICENSE
TX1245417294OtherGROUP NPI
TXCK3641OtherRR MEDICARE GROUP ID #
TX8A1844Medicare PIN
TXC15690Medicare UPIN