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Individual
PHILLIP WAYNE BOWDEN
Active
Individual
PHILLIP WAYNE BOWDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
N.P.
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
725718
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1548341274
BLUE CROSS BLUE SHIELD
TX
05
—
194753302
—
TX
01
—
AY8348
BLUE CROSS BLUE SHIELD
TX
01
—
P00633614
MEDICARE RAILROAD
TX
Enumeration date
10/18/2006
Last updated
05/20/2010
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