Provider Demographics
NPI:1306151162
Name:REX, JOHN HOWARD (MD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:HOWARD
Last Name:REX
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2617C W HOLCOMBE BLVD # 114
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77025-1601
Mailing Address - Country:US
Mailing Address - Phone:832-279-3107
Mailing Address - Fax:
Practice Address - Street 1:2617C W HOLCOMBE BLVD # 114
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77025-1601
Practice Address - Country:US
Practice Address - Phone:832-279-3107
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-17
Last Update Date:2010-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG8957207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP080H1776Medicaid
TX1322455OtherTEXAS PROVIDER IDENTIFICATION (TPI)
TXG8957OtherTEXAS MEDICAL LICENSE NUMBER
TX1322455OtherTEXAS PROVIDER IDENTIFICATION (TPI)