Provider Demographics
NPI:1740228196
Name:STOWERS, SCOTT C (DO)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:C
Last Name:STOWERS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 552
Mailing Address - Street 2:
Mailing Address - City:BRIDGEPORT
Mailing Address - State:TX
Mailing Address - Zip Code:76426-0552
Mailing Address - Country:US
Mailing Address - Phone:940-577-2090
Mailing Address - Fax:972-201-9667
Practice Address - Street 1:5575 WARREN PARKWAY
Practice Address - Street 2:PROFESSIONAL BUILDING I - SUITE 304
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-7503
Practice Address - Country:US
Practice Address - Phone:940-577-2090
Practice Address - Fax:972-201-9667
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-04
Last Update Date:2022-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH4733208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8FU759OtherBCBSTX
TX8FU759OtherBCBSTX