Individual
DR. TED E. FOGWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
8160 WALNUT HILL LN, SUITE 220, DALLAS, TX 75231-4339
(214) 750-0980
Mailing address
8160 WALNUT HILL LN, SUITE 220, DALLAS, TX 75231-4339
(214) 750-0980
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
E0917
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
169343401
—
TX
01
—
86X001
BCBS PROVIDER NUMBER
TX
Enumeration date
03/17/2006
Last updated
04/27/2022
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