Individual provider Active NPI

Alfred Harris Fowler III, DDS

  • General Practice Dentistry
  • Longview, TX
National Provider Identifier
1124158092
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
14501 Issued in TX
Practice address
444 Forest Square
Suite D
Longview, TX 75605-4463
Phone
(903) 236-8538
Fax
(903) 236-8539
NPI assigned
Mar 7, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 14501 TX Primary

Addresses

Primary practice location

444 Forest Square
Suite D
Longview, TX 75605-4463

Mailing address

444 Forest Square
Suite D
Longview, TX 75605-4463
Phone (903) 236-8538

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1124158092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "444 FOREST SQUARE",
            "address_2": "SUITE D",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756054463",
            "telephone_number": "903-236-8538",
            "fax_number": "903-236-8539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "444 FOREST SQUARE",
            "address_2": "SUITE D",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756054463",
            "telephone_number": "903-236-8538",
            "fax_number": "903-236-8539"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOWLER",
        "first_name": "ALFRED",
        "middle_name": "HARRIS",
        "name_suffix": "III",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "14501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Longview, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.