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Individual

CHARLES RICHARD FOX

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
LAT, ATC

Contact information

Practice address
1000 THE GREEN MILE, BURNET, TX 78611
(512) 756-4501
Mailing address
9920 COUNTY ROAD 210, BERTRAM, TX 78605
(512) 355-3086

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
ATO772
TX

Other

Enumeration date
04/25/2006
Last updated
07/08/2007
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