Provider Demographics
NPI:1427028430
Name:BUTLER, JOHN MOSER (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:MOSER
Last Name:BUTLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:16659 SOUTHWEST FREEWAY
Mailing Address - Street 2:MOB 2, SUITE 371
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-2375
Mailing Address - Country:US
Mailing Address - Phone:281-265-0760
Mailing Address - Fax:281-265-1240
Practice Address - Street 1:16659 SOUTHWEST FWY STE 371
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-2375
Practice Address - Country:US
Practice Address - Phone:281-265-0760
Practice Address - Fax:281-265-1240
Is Sole Proprietor?:No
Enumeration Date:2006-01-23
Last Update Date:2020-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ6359207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX118086106Medicaid
TX440003980OtherRAILROAD MEDICARE
TX440003980OtherRAILROAD MEDICARE
G43071Medicare UPIN