MEDICARE: DR. JOHN PARKS TROWBRIDGE M.D.

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	2083T0002X	Medical Toxicology (Preventive Medicine) Physician	F0052	TX

General Provider Information

NPI Number	:	1538291109
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN PARKS TROWBRIDGE M.D.

Provider Business Mailing Address
First Line	:	9816 MEMORIAL BLVD
Second Line	:	SUITE 205
City	:	HUMBLE
State	:	TX
Zip	:	77338-4255
Country	:	US
Telephone Number	:	281-540-2329
Fax Number	:	281-540-4329

Provider Business Practice Location Address
First Line	:	9816 MEMORIAL BLVD
Second Line	:	SUITE 205
City	:	HUMBLE
State	:	TX
Zip	:	77338-4255
Country	:	US
Telephone Number	:	281-540-2329
Fax Number	:	281-540-4329

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

Provider Enumeration Date	:	03/09/2007
Last Update Date	:	04/11/2013

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