Individual
JOHN WILLIAM LONGWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1500 CITYWEST BLVD, STE. 300, HOUSTON, TX 77042
(713) 620-4000
(713) 458-4229
Mailing address
PO BOX 840853, DALLAS, TX 75284-0853
(972) 233-1999
(972) 233-3666
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
L3735
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1735524 05
—
TX
05
—
173552406
—
TX
01
—
8AW311
BLUE CROSS BLUE SHIELD
TX
01
—
8X8780
BLUE CROSS PROVIDER ID
TX
01
—
P00461212
MEDICARE RAILROAD
TX
Enumeration date
10/16/2006
Last updated
06/04/2018
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