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NPI Code Detail

MEDICARE: JOHN M. HIGGINBOTHAM DO

MEDICARE: JOHN M. HIGGINBOTHAM DO
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
1208M00000XHospitalist PhysicianCOPS245NE
2207Q00000XFamily Medicine PhysicianN4470TX
3208M00000XHospitalist PhysicianDO-06874IA
4208M00000XHospitalist Physician6389TN
5208M00000XHospitalist Physician21973ND

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1790930899
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHN M. HIGGINBOTHAM DO
Provider Business Mailing Address
First Line : 12221 MERIT DRIVE
Second Line : SUITE 1500
City : DALLAS
State : TX
Zip : 75251
Country : US
Telephone Number : 214-217-1900
Fax Number : 940-627-7597
Provider Business Practice Location Address
First Line : 1300 W TERRELL AVE STE K230
Second Line :
City : FORT WORTH
State : TX
Zip : 76104-3104
Country : US
Telephone Number : 817-250-4906
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/18/2008
Last Update Date : 12/09/2025

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