Provider Demographics
NPI:1699896290
Name:FOX, JOAN HERRMANN
Entity type:Individual
Prefix:PROF
First Name:JOAN
Middle Name:HERRMANN
Last Name:FOX
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2127 FALL MEADOW DR
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77459-3335
Mailing Address - Country:US
Mailing Address - Phone:281-438-4127
Mailing Address - Fax:281-438-4127
Practice Address - Street 1:2127 FALL MEADOW DR
Practice Address - Street 2:
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77459-3335
Practice Address - Country:US
Practice Address - Phone:281-438-4127
Practice Address - Fax:281-438-4127
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX009306247200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other