Individual
PHILLIP WAYNE BOWDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
N.P.
Contact information
Practice address
6565 FANNIN ST # B452, HOUSTON, TX 77030-2703
(713) 441-3620
Mailing address
6565 FANNIN ST # B452, HOUSTON, TX 77030-2703
(713) 441-3620
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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