Provider Demographics
NPI:1932253325
Name:FOWLER, ELIZABETH M (EDD)
Entity type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:M
Last Name:FOWLER
Suffix:
Gender:F
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1020 HOLCOMBE BLVD
Mailing Address - Street 2:1304
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-2210
Mailing Address - Country:US
Mailing Address - Phone:713-795-5354
Mailing Address - Fax:713-795-4729
Practice Address - Street 1:1020 HOLCOMBE BLVD
Practice Address - Street 2:1304
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2210
Practice Address - Country:US
Practice Address - Phone:713-795-5354
Practice Address - Fax:713-795-4729
Is Sole Proprietor?:No
Enumeration Date:2007-01-22
Last Update Date:2008-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX23681103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical