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Individual

DONNELL KHALID BOWEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
1325 PENNSYLVANIA AVE STE 550, FORT WORTH, TX 76104-2148
(817) 250-7190
(817) 250-0116
Mailing address
3551 ROGER BROOKE DRIVE, SAN ANTONIO MILITARY MEDICAL CENTER, SAN ANTONIO, TX 78234

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
2015-01745
NC
208600000X
Surgery Physician
R5976
TX
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
2015-01745
NC
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
R5976
TX
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
06/18/2007
Last updated
08/13/2025
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