MEDICARE: DR. AUSTIN J DOWELL PHARMD

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
1	183500000X	Pharmacist	47124	TX

General Provider Information

NPI Number	:	1366003063
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AUSTIN J DOWELL PHARMD

Provider Business Mailing Address
First Line	:	4290 KINSEY DR STE 100
Second Line	:
City	:	TYLER
State	:	TX
Zip	:	75703-1022
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4290 KINSEY DR STE 100
Second Line	:
City	:	TYLER
State	:	TX
Zip	:	75703-1022
Country	:	US
Telephone Number	:	903-561-5656
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/24/2019
Last Update Date	:	06/24/2019

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