Provider Demographics
NPI:1992731137
Name:NOWLIN, SCOTT WARREN (MD)
Entity type:Individual
Prefix:
First Name:SCOTT
Middle Name:WARREN
Last Name:NOWLIN
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 1:2301 SOUTH MOPAC EXPRESSWAY
Mailing Address - Street 2:APT 1021
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78746
Mailing Address - Country:US
Mailing Address - Phone:301-631-9191
Mailing Address - Fax:301-631-1002
Practice Address - Street 1:720 W 34TH ST
Practice Address - Street 2:SUITE 101
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78705-1205
Practice Address - Country:US
Practice Address - Phone:512-452-8533
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-22
Last Update Date:2008-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0054261207P00000X
TXH3335207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX187294705Medicaid
MD762671100Medicaid
TX187294706Medicaid
TX187294701Medicaid
TX187294702Medicaid
TX187294704Medicaid
MD466250400Medicaid
TX187294703Medicaid
TX8J8135Medicare PIN
TX187294703Medicaid
TX187294706Medicaid
MD466250400Medicaid
TX8K1164Medicare PIN
TX8F6597Medicare PIN
TX187294705Medicaid
TX187294702Medicaid