Individual
DR. JACK M. BUTLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1504 TAUB LOOP, HOUSTON, TX 77030-1608
(713) 873-2000
Mailing address
2 GREENWAY PLZ, SUITE 900, HOUSTON, TX 77046-0297
(713) 798-1835
(713) 798-1144
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
L2828
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10651721
—
NM
05
—
155777902
—
TX
05
—
155777905
—
TX
01
—
8U6943
BCBS
TX
01
—
L2828
STATE LICENSE
TX
01
—
P00334341
RAILROAD
TX
Enumeration date
10/20/2005
Last updated
12/17/2009
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