Healthcare Provider Details

I. General information

NPI: 1285165357
Provider Name (Legal Business Name): MICHAEL DONALD MCDOWELL JR. DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/21/2017
Last Update Date: 04/22/2024
Certification Date: 04/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6410 FANNIN ST
HOUSTON TX
77030-3000
US

IV. Provider business mailing address

6431 FANNIN ST
HOUSTON TX
77030-1501
US

V. Phone/Fax

Practice location:
  • Phone: 832-325-6516
  • Fax:
Mailing address:
  • Phone: 713-500-5650
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number2017017626
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberS5700
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code2080P0214X
TaxonomyPediatric Pulmonology Physician
License NumberS5700
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: