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General NPI Number Information
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NPI Number | 1518061001
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Entity Type | Organization
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Legal Business Name | CENTRAL TEXAS ENT ASSOCIATES INC.
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Dates
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Enumeration Date | 09/12/2006
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Last Update Date | 08/26/2014
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Provider Practice Location Address
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Address Line | 2510 CROCKETT DR STE A
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City | BROWNWOOD
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State | TX
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Zip | 76801-5928
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Country | US
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Telephone | 325-646-9956
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Fax | 325-641-1010
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Provider Business Mailing Address
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Address Line | 2510 CROCKETT DR STE A
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City | BROWNWOOD
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State | TX
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Zip | 76801-5928
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Country | US
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Telephone | 325-646-9956
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Fax | 325-641-1010
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Authorized Official
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Title or Position | OWNER
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Name | DR. JAMES JOSEPH FOWLER
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Credential | M.D.
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Telephone | 325-646-9956
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | J5576
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License Number State | TX
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