Provider Demographics
NPI:1124122346
Name:FOWLER, JAMES DANIEL (DC)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:DANIEL
Last Name:FOWLER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3538 LAKEVIEW PKWY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ROWLETT
Mailing Address - State:TX
Mailing Address - Zip Code:75088-4090
Mailing Address - Country:US
Mailing Address - Phone:972-412-4442
Mailing Address - Fax:972-412-4469
Practice Address - Street 1:3538 LAKEVIEW PKWY
Practice Address - Street 2:STE 100
Practice Address - City:ROWLETT
Practice Address - State:TX
Practice Address - Zip Code:75088
Practice Address - Country:US
Practice Address - Phone:972-412-4442
Practice Address - Fax:972-412-4469
Is Sole Proprietor?:No
Enumeration Date:2006-09-08
Last Update Date:2012-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10161111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8F1977Medicare ID - Type Unspecified