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Active NPI 1982779195 Individual Practitioner Male Practitioner

Dr. Sidney Jack Fowler , DDS

Dentist - General Practice • Nacogdoches, TX

Professional Overview & Biography Verified Profile Summary

Dr. Sidney Fowler, DDS is a registered healthcare professional specializing in Dentist - General Practice in Nacogdoches, TX. Practice services are available at 1023 N MOUND ST STE D under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

1023 N Mound St Ste D

Nacogdoches, TX 759614453

Telephone 9365649401
Fax 9365643907
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Nacogdoches, TX

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 12.3 Yrs
Regional Practice Density
25 Specialists

Practicing in Nacogdoches, TX (10570 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2025-10-06
Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License TX 11803

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
120750805 (TX)
Medicaid State Provider ID
172282901 (TX)
Commercial Insurance / Payer ID Chips
G60111-01 (TX)

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

1 Associated Practitioners
Dr. Kimberly Biggs-Lewis , DDS

Dentist - General Practice

NPI 1053690966

Doctor of Dental Surgery

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

8 Historical Events
📍
Updated Practice Location October 06, 2025

Registered at 1023 N MOUND ST STE D, NACOGDOCHES, TX 759614453 (Tel: 9365649401)

📍
Updated Business Mailing Address October 06, 2025

Registered at PO BOX 617, SAN AUGUSTINE, TX 759720617 (Tel: 9365543496)

NPI Profile Active July 20, 2011

NPI status registered as active in NPPES database

📍
Updated Practice Location July 20, 2011

Registered at 1023 N MOUND ST, SUITE D, NACOGDOCHES, TX 759614491 (Tel: 9365649401)

📍
Updated Business Mailing Address July 20, 2011

Registered at 2314 US HIGHWAY 59 S, CARTHAGE, TX 756334924 (Tel: 9036900969)

👤
Provider Name / Credentials Updated July 20, 2011

Recorded as SIDNEY FOWLER, DDS

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 20, 2011

Dentist (License #11803 in TX)

🟢
Initial NPI Registration & Enumeration November 22, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1982779195
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: November 22, 2006
Last Update: October 06, 2025
Sole Proprietor: Yes

Mailing Address

Po Box 617

San Augustine, TX 759720617

Phone: 9365543496

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.