Provider Demographics
NPI:1396033809
Name:FOWLER, ALLISON SMITH (SLP-CCC)
Entity Type:Individual
Prefix:MRS
First Name:ALLISON
Middle Name:SMITH
Last Name:FOWLER
Suffix:
Gender:F
Credentials:SLP-CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10909 UPLAND PARK
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77043-4741
Mailing Address - Country:US
Mailing Address - Phone:281-498-8110
Mailing Address - Fax:
Practice Address - Street 1:4427 BELLE PARK DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77072-1815
Practice Address - Country:US
Practice Address - Phone:281-498-8110
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-18
Last Update Date:2022-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11476235Z00000X
TX113131235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0657199-01Medicaid