Fowler, Justin
Fowler, Justin is an individual health care provider with primary practice located at 3551 Roger Brooke Dr , Fort Sam Houston TX 78234-4504. He recently has 2 registered licenses in different health care specialties including Other Service Providers / Military Health Care Provider, Allopathic & Osteopathic Physicians / Orthopaedic Trauma. Allopathic & Osteopathic Physicians / Orthopaedic Trauma is his primary health care specialty. Fowler, Justin can be contacted via phone (210) 539-9582.Contact Information
Primary practice address
3551 Roger Brooke Dr
Fort Sam Houston TX 78234-4504
Phone: (210) 539-9582
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Military Health Care Provider | 171000000X | ||
| Allopathic & Osteopathic Physicians / Orthopaedic Trauma | 207XX0801X | MD2014-0304 | New Mexico |
| Allopathic & Osteopathic Physicians / Orthopaedic Trauma | 207XX0801X | 2016027259 | Missouri |
| Allopathic & Osteopathic Physicians / Orthopaedic Trauma | 207XX0801X | Q6009 | Texas |
Profile Details
| NPI number | 1386835585 |
|---|---|
| LBN Legal business name | Fowler, Justin |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 5th, 2007 |
| Last updated | Jun 3rd, 2021 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1386835585 | NPPES |
| Texas | Other | 1L5640 | MEDICARE |
| Texas | MEDICAID | 390382503 | MEDICARE |
| Texas | Other | P02601779 | MEDICARE |
| Texas | Other | 2016027259 | MEDICARE |
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