Basic Information
| Provider Information | |||||||||
| NPI: | 1639177959 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DOWNS | ||||||||
| FirstName: | MICHAEL | ||||||||
| MiddleName: | REID | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 300 E 6TH ST | ||||||||
| Address2: | |||||||||
| City: | TEXARKANA | ||||||||
| State: | AR | ||||||||
| PostalCode: | 718545207 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8707796000 | ||||||||
| FaxNumber: | 8707796093 | ||||||||
| Practice Location | |||||||||
| Address1: | 300 E 6TH ST | ||||||||
| Address2: | |||||||||
| City: | TEXARKANA | ||||||||
| State: | AR | ||||||||
| PostalCode: | 718545207 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8707796000 | ||||||||
| FaxNumber: | 8707796093 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/11/2005 | ||||||||
| LastUpdateDate: | 10/24/2013 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | C6206 | AZ | Y | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | K4344 | TX | N | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 114496001 | 05 | TX | MEDICAID | 058882402 | 05 | TX | MEDICAID |