Provider Demographics
NPI:1427516350
Name:COX, RALEIGH D IV (LVN)
Entity type:Individual
Prefix:
First Name:RALEIGH
Middle Name:D
Last Name:COX
Suffix:IV
Gender:M
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19568 FONDA ST E APT 2
Mailing Address - Street 2:
Mailing Address - City:WHITEHOUSE
Mailing Address - State:TX
Mailing Address - Zip Code:75791-5960
Mailing Address - Country:US
Mailing Address - Phone:409-423-9969
Mailing Address - Fax:
Practice Address - Street 1:19568 FONDA ST E APT 2
Practice Address - Street 2:
Practice Address - City:WHITEHOUSE
Practice Address - State:TX
Practice Address - Zip Code:75791-5960
Practice Address - Country:US
Practice Address - Phone:409-422-9969
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-11
Last Update Date:2019-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX329843164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse