Provider Demographics
NPI:1659377604
Name:FOWLER, ELIZABETH SANCHEZ (MD)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:SANCHEZ
Last Name:FOWLER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:455 SCHOOL ST
Mailing Address - Street 2:STE 26
Mailing Address - City:TOMBALL
Mailing Address - State:TX
Mailing Address - Zip Code:77375-4597
Mailing Address - Country:US
Mailing Address - Phone:281-374-9700
Mailing Address - Fax:281-370-8765
Practice Address - Street 1:455 SCHOOL ST
Practice Address - Street 2:STE 26
Practice Address - City:TOMBALL
Practice Address - State:TX
Practice Address - Zip Code:77375-4597
Practice Address - Country:US
Practice Address - Phone:281-374-9700
Practice Address - Fax:281-370-8765
Is Sole Proprietor?:No
Enumeration Date:2005-06-23
Last Update Date:2015-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL8340208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXI10021Medicare UPIN
TX8P2000OtherBLUE CROSS & BLUE SHIELD
TXL8340OtherMEDICAL LICENSE
TX169880501Medicaid
TX8C0696Medicare ID - Type Unspecified
TX760530251OtherTAX ID