Active NPI
Jody M Fowler
- Pharmacist
- Tyler, TX
National Provider Identifier
1871829507
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 37337
- Practice address
- 2120 Ese Loop323
Tyler, TX 75701-8318 - Phone
- (903) 593-1507
- NPI assigned
- Oct 31, 2009
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 37337 | TX | Primary |
Addresses
Primary practice location
2120 Ese Loop323
Tyler, TX 75701-8318
Mailing address
2120 Ese Loop323
Tyler, TX 75701-8318
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 37337 | TX | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Pharmacy
- Tyler, TX
- NPI 1083624951
-
- Pharmacy
- Longview, TX
- NPI 1629956545
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1256947200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1256947200000",
"number": "1871829507",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2120 ESE LOOP323",
"city": "TYLER",
"state": "TX",
"postal_code": "757018318"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2120 ESE LOOP323",
"city": "TYLER",
"state": "TX",
"postal_code": "757018318",
"telephone_number": "903-593-1507"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FOWLER",
"first_name": "JODY",
"middle_name": "M",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-10-31",
"last_updated": "2009-10-31",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TX",
"license": "37337",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tyler, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.