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NPI Code Detail

MEDICARE: MICHELE M. FOWLER D.O.

MEDICARE: MICHELE M. FOWLER D.O.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207PE0004XEmergency Medical Services (Emergency Medicine) Physician3752OK
2207P00000XEmergency Medicine PhysicianP2443TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1306832522
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHELE M. FOWLER D.O.
Provider Business Mailing Address
First Line : PO BOX 269024
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73126-9024
Country : US
Telephone Number : 866-321-8433
Fax Number :
Provider Business Practice Location Address
First Line : 23900 KATY FWY
Second Line :
City : KATY
State : TX
Zip : 77494-1323
Country : US
Telephone Number : 281-644-7000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/22/2005
Last Update Date : 10/01/2019

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