Provider Demographics
NPI:1457453912
Name:CAWYER, JOHN CURTIS JR (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:CURTIS
Last Name:CAWYER
Suffix:JR
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 1:4217 MIRA MONTE LN
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76179-6819
Mailing Address - Country:US
Mailing Address - Phone:817-750-1601
Mailing Address - Fax:
Practice Address - Street 1:4217 MIRA MONTE LN
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76179-6819
Practice Address - Country:US
Practice Address - Phone:817-750-1601
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-03
Last Update Date:2008-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM3970207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX184637005Medicaid
TX0041PTOtherBCBS
TX8G7459OtherBCBS
TX184637004Medicaid
TXP00418296OtherRAILROAD MCARE
TX8G7459OtherBCBS
TX0041PTOtherBCBS
TXP00457413Medicare PIN
TXP00418296OtherRAILROAD MCARE