John Joseph Poulin, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

T2045 Issued in TX

Practice address

3551 Roger Brooke Drive
San Antonio Military Medical Center
Fort Sam Houston, TX 78234-6200

Phone

(210) 916-0707

Fax

(210) 916-6349

NPI assigned

Jul 23, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1185148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653436800000",
    "number": "1932309572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3551 ROGER BROOKE DRIVE",
            "address_2": "SAN ANTONIO MILITARY MEDICAL CENTER",
            "city": "FORT SAM HOUSTON",
            "state": "TX",
            "postal_code": "782346200",
            "telephone_number": "210-916-0707",
            "fax_number": "210-916-6349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3551 ROGER BROOKE DRIVE",
            "address_2": "SAN ANTONIO MILITARY MEDICAL CENTER",
            "city": "FORT SAM HOUSTON",
            "state": "TX",
            "postal_code": "782346200",
            "telephone_number": "210-916-0707",
            "fax_number": "210-916-6349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POULIN",
        "first_name": "JOHN",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-23",
        "last_updated": "2022-05-25",
        "certification_date": "2022-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "T2045",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Josephine Porter, PH.D.
• Samuel Louis Posey, MD
• Emily Pospiech, MD
• Aron R. Potter, PSY.D.
• Rebecca Joyce Potter, BSN RN
• Michael R Povlow, MD
• Jacob Powell, D.O.
• Whitney Elizabeth Powell, LCSW
• Chhouen Prach, MD
• Ebony Prater-Henderson, DROT, MOTR/L

• Pediatrics Physician in Fort Sam Houston, TX
• Providers in Fort Sam Houston, TX by specialty
• Pediatrics Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.