Look up the most recent NPI and PECOS records

John M. Higginbotham

Family Medicine

Allopathic & Osteopathic Physicians

1300 W Terrell Ave Ste K230, Fort Worth, TX 76104-3104

(817) 250-4906 (214) 217-1900

PECOS Enrollment

This provider is enrolled in PECOS as JOHN HIGGINBOTHAM.

Based on the most recent information from CMS, provider John M. Higginbotham is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 3 days ago.

Profile Details

Provider ID
1790930899
Provider Type
Individual
Full Name
Higginbotham, John M.
Credential
DO

Gender
Male
Sole Proprietor
No
Enumeration Date
11/18/2008
Last Updated
2/22/2023

Contact Information

Practice Location

1300 W Terrell Ave Ste K230, Fort Worth, TX 76104-3104

(817) 250-4906

Unlisted Fax

Mailing Location

12221 Merit Drive, Suite 1500, Dallas, TX 75251

(214) 217-1900

(940) 627-7597

Provider Taxonomies

Code	Description	License
Code 207Q00000X Primary	Description Family Medicine Allopathic & Osteopathic Physicians	License N4470 Texas

Provider Identifiers

ID	Description	Issuer
ID 282187801	Description Medicaid	Issuer Unlisted Texas

John M. Higginbotham

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

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Criswell, Jared

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Rogers, Amber Rachelle

Jackson, Masheika S

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Wix, Kurtt R

Lowe, Eddie