Provider Demographics
NPI:1114959301
Name:WALKER, JOHN E (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:E
Last Name:WALKER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8000 RESEARCH FOREST DR
Mailing Address - Street 2:360
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77382-1504
Mailing Address - Country:US
Mailing Address - Phone:281-292-1191
Mailing Address - Fax:281-362-9170
Practice Address - Street 1:8000 RESEARCH FOREST DR
Practice Address - Street 2:360
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77382-1504
Practice Address - Country:US
Practice Address - Phone:281-292-1191
Practice Address - Fax:281-362-9170
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2012-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH2974207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
4778957OtherAETNA
TX8M5231OtherBLUE CROSS BLUE SHIELD
TX800624Medicare ID - Type Unspecified
TX8M5231OtherBLUE CROSS BLUE SHIELD