Provider Demographics
NPI:1891790499
Name:FOWLER, JAMES J (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:J
Last Name:FOWLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:2510 CROCKETT DR STE A
Mailing Address - Street 2:
Mailing Address - City:BROWNWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:76801-5928
Mailing Address - Country:US
Mailing Address - Phone:325-646-9956
Mailing Address - Fax:325-641-1010
Practice Address - Street 1:2510 CROCKETT DR STE A
Practice Address - Street 2:
Practice Address - City:BROWNWOOD
Practice Address - State:TX
Practice Address - Zip Code:76801-5928
Practice Address - Country:US
Practice Address - Phone:325-646-9956
Practice Address - Fax:325-641-1010
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-20
Last Update Date:2017-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ5576207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX4230462OtherAETNA PROVIDER NUMBER
TX126625604Medicaid
TX0019CUOtherBCBS - BROWNWOOD
TX180953102OtherUNITED HEALTHCARE PROV NO
TX1844073001OtherCIGNA PROVIDER NUMBER
TX89119GOtherBCBS PROVIDER NUMBER
TX040012679OtherRR MEDICARE - BROWNWOOD
TX040015413OtherRAILROAD MEDICARE
TX112950100OtherFIRST CARE PROVIDER NUMBE
TX126625601Medicaid
TX126625601Medicaid
TX0019CUOtherBCBS - BROWNWOOD
TX126625601Medicaid