Provider Demographics
NPI:1790733038
Name:HOWTON, JOHNNY D JR (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHNNY
Middle Name:D
Last Name:HOWTON
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:PO BOX 848491
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-8491
Mailing Address - Country:US
Mailing Address - Phone:254-724-2111
Mailing Address - Fax:
Practice Address - Street 1:50 HILLCREST MEDICAL BLVD STE 105
Practice Address - Street 2:
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76712-8953
Practice Address - Country:US
Practice Address - Phone:254-754-1522
Practice Address - Fax:254-754-1974
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-05
Last Update Date:2022-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ0006174400000X, 208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX280000859OtherMEDICARE RAILROAD
TX5468182001OtherCIGNA
TX0062CNOtherBCBS
TX115525100OtherFIRSTCARE
TX127409405Medicaid
TX1142829OtherFIRST HEALTH
TX1254330001OtherDME
TX0040237OtherHARRIS METHODIST
TX1254330001OtherDME
TX00024JMedicare ID - Type UnspecifiedMEDICARE