Individual
DUSTIN FOWLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Taxonomy
Speciality
Code
Description
License number
State
207KA0200X
Allergy Physician
Primary
S1399
TX
207R00000X
Internal Medicine Physician
LL37667
SC
208000000X
Pediatrics Physician
LL37667
SC
Other
Enumeration date
06/10/2015
Last updated
07/28/2021
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