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Organization
LAURENCE ROBERT BOWER III
Active
Organization
LAURENCE ROBERT BOWER III
Active
Other names
CENTRAL TEXAS OPEN MRI
Organization subpart
No
Provider details
NPI number
Authorized official
PAULA DELEON (ADMINISTRATOR)
(830) 632-7562
Entity
Organization
Contact information
Practice address
19A GRUENE PARK DRIVE, NEW BRAUNFELS, TX 78130
(830) 606-1200
(830) 606-1276
Mailing address
19A GRUENE PARK DR, NEW BRAUNFELS, TX 78130-2484
(830) 632-7562
(830) 632-6793
Taxonomy
Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
Primary
—
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0047RG
BLUECROSS BLUESHIELD
TX
05
—
364400701
—
TX
Enumeration date
09/17/2006
Last updated
08/23/2018
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