Individual
JOHN W IDOUX
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2601 THORNTON LN, TEMPLE, TX 76502-1808
(254) 724-6622
(254) 742-6620
Mailing address
PO BOX 844658, DALLAS, TX 75284-4658
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
N5119
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
215792701
—
TX
Enumeration date
01/04/2007
Last updated
12/23/2021
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