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Individual
GRANT C FOWLER
Active
Individual
GRANT C FOWLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
G8111
TX
207QG0300X
Geriatric Medicine (Family Medicine) Physician
G8111
TX
207RS0010X
Sports Medicine (Internal Medicine) Physician
G8111
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
137012401
CSHCN
TX
05
—
137012405
—
TX
01
—
88Y812
BCBS
TX
Enumeration date
07/11/2006
Last updated
08/03/2016
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