Provider Demographics
NPI:1962468264
Name:DOW, JOEL RAY (DO)
Entity Type:Individual
Prefix:
First Name:JOEL
Middle Name:RAY
Last Name:DOW
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 1:18568 FORTY SIX PKWY
Mailing Address - Street 2:STE 1001
Mailing Address - City:SPRING BRANCH
Mailing Address - State:TX
Mailing Address - Zip Code:78070-6878
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:HWY 281 SOUTH
Practice Address - Street 2:
Practice Address - City:BURNET
Practice Address - State:TX
Practice Address - Zip Code:78611-1219
Practice Address - Country:US
Practice Address - Phone:512-715-3010
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-25
Last Update Date:2021-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL6361207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8S6919OtherBCBS
TX164949304OtherCSHCN
TX164949305Medicaid
TX8K1873OtherBCBS
TX164949306OtherCSHCN
TX164949303Medicaid
TX8G6381Medicare PIN
TX8S6919OtherBCBS
TX8J6972Medicare PIN
TXP00450285Medicare UPIN
TXP00438089Medicare PIN
TX8D6406Medicare PIN
TX8K1293Medicare PIN