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NPI Code Detail

MEDICARE: MRS. DARRAH D FOWLER NNP

MEDICARE: MRS. DARRAH D FOWLER NNP
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
12080N0001XNeonatal-Perinatal Medicine Physician251519TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1251519OTHERTXNURSING LICENSE

General Provider Information

NPI Number : 1184688079
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. DARRAH D FOWLER NNP
Provider Business Mailing Address
First Line : 5414 FREDERICKSBURG RD
Second Line : SUITE 100
City : SAN ANTONIO
State : TX
Zip : 78229-3641
Country : US
Telephone Number : 210-541-8281
Fax Number : 210-541-9123
Provider Business Practice Location Address
First Line : 5414 FREDERICKSBURG RD
Second Line : SUITE 100
City : SAN ANTONIO
State : TX
Zip : 78229-3641
Country : US
Telephone Number : 210-541-8281
Fax Number : 210-541-9123
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/17/2006
Last Update Date : 07/08/2007

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