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Organization
MAIN ST. MEDICAL CENTER OF VIDOR
Active
Organization
MAIN ST. MEDICAL CENTER OF VIDOR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DUNCAN G BOWELL M.D. (DOCTOR)
(409) 769-0237
Entity
Organization
Contact information
Practice address
1091 N MAIN ST, STE B, VIDOR, TX 77662-4339
(409) 769-0237
(409) 769-0254
Mailing address
1091 N MAIN ST, STE B, VIDOR, TX 77662-4339
(409) 769-0237
(409) 769-0254
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MDE9547
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0017MH
BCBS
TX
01
—
P00298682
RAILROAD MEDICARE
TX
Enumeration date
07/18/2007
Last updated
07/18/2007
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